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BY PA.STON COOIPI^R. 



THE AMERIOAH 

HOUSEHOLD BOOK OF MEDICINE, 

OB 

EVERT ONE'S GUIDE IN SICKNESS: 

CONTAINING 

DIRECTIONS ON THE DISEASES OF MEN, WOMEN, AND CHILDREN; 

ON BATHING, DIET, EXERCISE, AND NURSING THE SICK; 

ON CLIMATE, MINERAL WATERS, &c., &c.; 

WEITTEN IN PLAIN LANGUAGE, AND ADAPTED TO 

POPULAR USE AND READY REFERENCE 

BY MEANS OF A COMPLETE 

INDEX OF SYMPTOMS AND TREATMENT AND A 
NATURAL CLASSIFICATION OF SUBJECTS. 



By JOHjS" JAMES, M. D., Etc., Etc., 

ASSISTED BY AN EMINENT WESTERN PHYSICIAN. 



Illustrated. 



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ci:^rci:N':N'ATi: 

E. W. CARROLL & CO., PUBLISHERS, 

117 WEST FOURTH STREET. 

1866. 

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Entered according to Act of Congress, in the year 1866, by 
R. W. CARROLL & CO., 

In the Clerk's Office of the District Court of the United States for the Southern 

District of Ohio. 



FRONT VIEW OF THE MUSCLES OF THE BODY. 



1, Frontal Bellies of the Occipito-Frontalis. 
2, Orbicularis Palpebrarum. 3, Levator Labii 
Superioris Alaeque Nasi. 4, Zygomatieus Mi- 
nor. 5, Zygomatieus Major. 6, Masseter. 7, 
Obicularis Oris. 8, Depressor Labii Inferioris. 
9, Platysma-Myoides. 10, Deltoid. ll,Pecto- 
ralis Major. 12, Axillary portion of the Latis- 
simus Dorsi. 13, Serratus 
Major Antieus. 14 
Flexor Cubiti. 15, Anterior 
portion of the Triceps Ex- 
tensor Cubiti. 16, Supinator 
Radii Longus. 17, Pronator ^'^■ 

Eadii Teres. 18, Extensor 




Carpi Radialis Longior. 19, 
Extensor Ossis Metacarpi 
Pollicis. 20, Annular Liga- 
ment. 21, Palmar Fascia. 
22, Obliquus Externis Ab- 
dominis. 23, LineaAlba. 24, 
Tensor Vaginae Femoris. 25, 
Section of the Spermatic 
Cord. 26, Psoas Magnus. 
27, Adductor Longue. 28, 
Sartorius. 29, Rectus Fe- 
moris. 30, Vastus Exter- 
nus. 31, Vastus Internus. 
32, Tendon Patellae. 33, Gas- 
trocnemius. 34, Tibialis An- 
tieus. 35, Tibia. 36, Ten- 
dons of the Extensor Com- 



REAR VIEW OF THE MUSCLES OF THE BODY.' 



1, Temporalis. 2, Occipital portion of 
the Oecipito-Frontalis. 3, Complexus. 
4,Splenius. 5, Masseter. 6, Sterno-Cleido 
Mastoideus. 7, Trapezius. 8, Deltoid. 9, 
Infra-Spinatus. 10, Triceps Extensor. 11, 
Teres Minor. 12, Teres Major. 13, Ten- 
dinous portion of the Triceps. 14, Ante- 
rior edge of the Triceps. 15, 
Supinator Radii Longus. 16, 
Pronator Radii Teres. 17, Ex- 
g tensor Communis Digitorum. 

18, Oxtensor Ossis Metacarpi 
Pollicis. 19, Extensor Com- 




munis Digitorem Tendons. 20, 
Olecranon and Insertion of the 
Triceps. 21, Extensor Carpi Ul- 
naris. 22, Auricularis. 23, Ex- 
tensor Communis. 24, Latissimus 
Dorsi. 25, Its Tendinous Origin. 
26, Posterior part of the Obliquu3 
Externus. 27, Gluteus Medius. 
28, Gluteus Magnus. 29, Biceps 
Flexor Cruris. 30, Semi-Tendin- 
osus. 31, 32, Gastrocnemius. 33, 
Tendo-Achilles. 



PREFACE. 



In offering this work to the public, we can not forbear a few 
remarks on its great importance to the health and happiness of 
the mass who are removed from easy access to physicians, and, 
therefore, exposed to disease, without any protection except such 
strength of constitution as a kind Providence may have given 
them. Frequently, no hardiness of constitution, unaided, can re- 
sist the attacks of disease, while delicate persons, with judicious 
management, may long survive their robust but careless or ignorant 
neighbors. In the absence of a medical attendant, it is of vital 
importance to have at hand such a work as this is believed to be, 
which gives, in a clear and popular style, the practical result of 
the experience and learning of preceding ages, as applied to the 
treatment of ordinary diseases, the management of the sick, and 
the prevention of " the ills which flesh is heir to." 

It is not pretended that this work will or should supersede 
proper medical advice. On the co.ntrary, it is merely an assistant to 
be relied upon in cases where but little is needed, or where a phy- 
sician can not be procured. We leave to quacks and quack books 
such absurd professions and such injurious advice as lead people 
to trust in specifics, nostrums, and all manner of patent medicines, 
to the exclusion of treatment at the hands of scientific physicians 
of the regular school, and such medicines as long experience and 
patient investigation have proven to be useful in the prevention 
or cure of disease. This book rejects quackery in whatever guise 

(v) 



VI PREFACE. 

it may appear. It recognizes nothing but charlatanism in every 
effort to cast aside the results of science, as developed by ages of 
study, for the whimsicalities of so-called reformers, which spring 
fully armed from the heads of their authors, like the fabled Minerva 
from the head of Jupiter. Only inspiration can afford to ignore 
past experience, and this work is published in the belief that the 
age of miracles is gone. 

Acting on this theory, we profess to offer but little that is new 
or original. We merely add a combined observation, covering half 
a century, to the result of the toil of a thousand years. We hope 
and believe that in doing this humble work we shall be in some 
measure assisting to stem the tide of quackery which, at times, 
seems to be on the point of overflowing the whole country, and 
washing away, with its foul isms, every landmark of science and 
every light-house of experience. We confidently appeal to phy- 
sicians of the regular school throughout the country to examine 
the book carefully, and, if it be what we profess it is, to use their 
influence to secure its circulation among the people ; and we have 
no hesitation in saying that they will be aiding in the propagation 
of valuable knowledge, in the preservation of human life, and in 
the eradication of quackery. 

This work treats of nearly every phase of disease, and of 
sanitary matters in general. It begins with the prevention of dis- 
ease, as being the most natural method of treating the subject of 
health. Under this head it treats of the noxious agents which 
produce disease, of atmospheric air, of the effect of the rays of 
the sun, of vitiated air, of respiration, of fire-places and ven- 
tilation, of endemic and epidemic influences, of malaria and the 
effects of miasms. It then proceeds to the consideration of men- 
tal affections, and, in this connection, of sleep and its effects. 
Next, it treats of exercise, with some directions as to the kind 
and quantity of it best adapted to the promotion of health. It 
then takes up the subject of the secretions, which are explained in 
a clear manner. Under this head the matter of baths and bathing 



PREFACE Vil 

is fully discussed, showing wherein a proper use of water is a pre- 
ventive of many ills of the body, and wherein we should beware 
of its excessive use to the exclusion of proper remedies, as is prac- 
ticed by one class of quacks. This is followed by an article on 
food and diet, with a discussion of the matter of eating with refer- 
ence to health. 

Chapter II is devoted to an elaborate article on the Climatology 
of the United States, in which much interesting and useful infor- 
mation is imparted touching the healthfulness or unhealthfulness 
of nearly every portion of the country. To travelers, and those 
desiring to emigrate, this article must be of great value, as it con- 
denses and popularizes a vast amount of knowledge on the subject. 
No person can safely venture to break up his home connections, 
to seek another dwelling-place for himself and family, without 
studying the climate of the country he desires to reside in, and it 
is very difficult to find this subject fully treated of in any accessi- 
ble form. 

Mineral waters are next taken up. and discussed in a manner 
which must be useful to any one desiring to seek health by resort- 
ing to places of gayety, either in this country or Europe. 

The reader will next find a chapter devoted to diseases in gen- 
eral, in which nearly every possible affection, not mentioned else- 
where, is treated of. 

We next come to Diseases of Women, to which is devoted a long 
chapter, and one that is second to none in importance. The dis- 
eases which affect a female are frequently such as delicacy pre- 
vents her from disclosing, and the consequence often is that she 
goes on from year to year, and finally dies for want of proper 
treatment. Could she have had this work to consult, in all prob- 
ability she would have discovered what afi'ected her, and its reme- 
dies ; or else would have seen the absolute necessity of procuring 
proper medical treatment, and might have been long spared to 
enjoy life herself, or to contribute to the happiness of her family 
and friends. 



Viii PREFACE. 

Next only in importance to this chapter on Diseases of Women 
is the one which follows it, on Diseases of Children. When we 
contemplate the fearful mortality among children, growing out of 
the ignorance of parents, the heart sickens. There is no reason 
why disease should be so fatal to children, except that parents 
have not at hand the proper books. Such a work as this, which 
designs to popularize science, is a vade mecum in every household, 
for the safety of young as well as old. 

The work gives one chapter to Physiology and the Laws of Life, 
and another to Gymnastics and Physical Training, both interest- 
ing subjects. ' 

We can not permit this book to go to press without calling 
especial attention to the article on Cholera, in chapter IV. Now 
that this terrible disease is already among us, every one should 
be posted upon the subject. It is a disease which requires 
prompt, decided, and judicious treatmeiit. No time can safely be 
lost, even in waiting for a physician. To be safely treated it 
must be taken in its incipient stages, before the dreadful rice-water 
discharges and the collapse set in. When these are present but 
little can be looked for, though careful and decided treatment may, 
even then, accomplish much. This article on Cholera is from the 
pen of a physician who has had most extensive and varied expe- 
rience in the treatment of the disease. His practice extended 
through the epidemics of 1832-33, and 1849-50, and was very 
large. 

A marked and exclusive feature of this work is its Guide to 
Diagnosis, or Index of Symptoms, by which the reader can find 
the treatment prescribed for his symptoms with perfect ease and 
certainty. It merely carries out the idea of an index to its proper 
conclusions ; that is, making it so complete that any information 
to be had in the book can be got at without delay. 



CONTENTS. 

CHAPTER I. — Prevention of Disease. 

(Page 17-96.) 

Prevention of disease. — Noxious agents — Conservative powers — Atmosphere 
and air as causes of disease — Calorific and colorific rays of the sun — Compo- 
sition of air — Vitiation of air by the respiration — Arterial blood — Purification 
of blood — Quantity of oxygen and of air necessary to life — Components of animal 
matter — Too much carbon poisonous — Fire-places — Heated air — Contrivances for 
ventilation — The temperature of the air — Efi'ects of high and low temperature 
of air — Humidity of atmosphere — Influence of light on animals — Atmospheric 
impurities, and their causes — Propositions for -due ventilation — Electric varia- 
tions — Endemic and epidemic influences — Malaria — Agues endemic — Effects of 
miasms : laws regulating their origin — Advice respecting malaria — Jeffrey's 
respirator. 

Mental affections, as causes of disease. — Three conditions necessary for 
healthy brain — Effects of too much and too little exercise of the intellect — Edu- 
cation of children and young growing persons — Examples of over-study and 
of precocious intellect — Teaching at schools — Imaginative faculty to be less cul- 
tivated than it is. 

On sleep,— Quantity necessary; too much disposes to apoplexy; too little to 
exhaustion of powers — Bedrooms, what they should be. 

Exercise. — Exercise essential; to be properly regulated — Effects of pressure 
of too tight corsets on muscles of the body — Wasp-waists condemned — Children 
chicken-breasted — Mothers should nurse their own children — Muscular exercise ; 
its effects — Hours for exercise — Walking exercise preferable. 

The secretions. — Cruveilhier's index of health — Waste and supply — Secret- 
ing vessels — Absorbents — Mesenteric glands — Thoracic duct — The chyle — Atro- 
phy — Effete or waste matters — Superabundance of carbon poisonous — Bile, its 
atomic composition — Purifying organs; quantity daily removed from the human 
body; how remedied — Ingesta and egesta, or incomings and outgoings — Bile,, 
and its purposes — The chyme, when acid, when alkaline — Fat — Theory of Ber- 
nard — Uses of bile — Bilious disorders, their kinds, causes, and treatment — 
English cholera — Liver disease in tropical climates — The skin — Perspiratory 
pores described — Necessity of attention to the skin — Matters thrown off in per- 
spiration — Fat, its use — The surface of body not to be chilled — Cold feet — Baths — 
Temperature of baths — The cold bath; the tepid and warm baths — Rules — A 
simple portable warm bath — The hot bath; the vapor bath; the shower bath, 
and mode of managing it ; the hip bath ; the foot bath — The nitromuriatic acid 
(ix) 



X CONTENTS. 

bath in liver complaints — hot douche bath — Imitation of bath of Aix in Sayoy — 
Uses of hot douche — Air-pump vapor bath — Shower bath — Cold bathing, and 
cold water drank ; when dangerous — Advice to fashionable party-goers — Tepid 
baths — Warm baths — Hydropathy — Quackery — Perkins' metallic tractors — Ho- 
meopathy — Law of vicarious action — Baths of hydropathists : the sudorific, the 
shallow bath, the wet sheet, the sitz bath, douche, foot bath, wet spinal friction, 
etc.; wet sheet packing lauded; umschlags — Rationale of action by hydropa- 
thists — Hydropathy useful as an auxiliary — Opponents of doctors and drugs 
obliged to seek advice and help from doctors — Hydropathy not attainable by the 
poor man. 

On food and diet. — Vital action, accompanied by waste of structures — Supply 
necessary — Two vital processes going on always — Nitrogenized and non-nitro- 
genous articles of food — Albumen, fibrine, and caseine — Nutrition of the animal 
tissues, through absorption of albumen, and its conversion into fibrine — Means 
to ends — Cookery of food — Salting, smoking, pickling — Sausages, etc., poisonous; 
why, not known — Boiling, its effects on meat — Roasting, broiling, baking, 
frying — Advice to dyspeptics. 

Times op eating. — Breakfast, luncheon, dinner, tea, supper — Rules as to 
eating — Quantity of food — Vitellius' gluttony — Old age may be delayed in its 
oncoming, but can not be protracted — Annual consumption of meat of certain 
nations — Disorders of repletion, infesting middle life, fatal to many — Instances 
of death from indulgence ; directions to such persons — Animal and vegetable 
food contrasted in certain respects — Vegetables — Soups — Fat of the body — Acid- 
ity of stomach, causes of — Unfermented bread — Moldy bread — Rich cakes, etc., 
bad; all pastry, some puddings — Butcher's meat, order of digestibility — Pork, 
venison, and game; birds, fish, potatoes, peas, beans, nuts, grapes, pears, 
oranges — Drink proper for indigestion and dyspeptics — Condiments condemned. 

Vegetarians and drinks. — Vegetable diet, exclusive use of, opposed — Such 
a diet is not the cause of peaceable dispositions — Carnivorous beasts of prey — A 
mixed diet proper for man — Cautions as to vegetarianism, especially to pregnant 
women — Drinks, alcoholic and others — Ales, porter — Wines of different countries; 
effects of time on them — Sugary wines — Acid in wines — Beer — Use of wines 
contrasted with spirit drinking — Wines proper for the dyspeptic, for the 
gouty — Port wine — Madeira — Champagne — Johannisberger — Schartzberger — 
Claret wines — Burgundy — Ardent spirits — Proof of alcohol — Brandy — Cordial 
mixture in typhus, etc. — Rum — Gin — Whisky — Arrack — Ratafias — Kirschwas- 
sers — Maraschino — Curacoa — Effects of alcohol — When to be drank. 

Spontaneous combustion — Improbability and impossibility of it in the human 
body. 

Cookery por the sick and convalescent. — Boiling — Roasting — Baking — 
Frying — Cookery for the sick-room — Arrowroot — Mucilage — Tons les mois — 
Sago — Tapioca — Salep — Grit gruel — Oatmeal gruel — Iceland moss — Irish moss, 
or carrageen — Rice — Ground rice — Milk — Bread panada. 

Animal preparations. — Hartshorn jelly — Beef tea — Chicken tea — Veal tea — 
Mutton tea — Turtle soup — Toast water — Apple tea — Lemon-peel water — Orgeat — 
Raspberry vinegar water — Lemonade — Simple barley water, compound ditto- 
Almond emulsion — Marsh-mallow tea — Linseed tea — Rennet whey — Vinegar and 
tamarind wheys — White wine whey — Mustard whey — Artificial goats' milk — 
Artificial asses' milk — Milk and soda-water — Buttermilk — Sago posset. 

Cookery fob the convalescent. — Boiled flour and milk — Arrowroot pud- 



CONTENTS. XI 

ding — Anon-root blanc-mange — Milk or beef tea arrowroot mucilage — Flummery 
or SGwans — Oatmeal porridge — Rice and apples, or snowballg — Boiled bread pud- 
ding — Simple rice ditto — Macaroni or vermicelli ditto — Batter ditto — Tapioca 
ditto — Mashed carrots and turnips — Plain boiled vegetables. 

Animal preparations. — Soup of rice, vermicelli, or macaroni — Chicken 
broth — Chicken panada — Rice gravy — Gloucester jelly — Sago milk — Mutton 
broth with vegetables — Tripe — Sweetbread — Fowl with rice — Water souchy — 
Broiled whiting — Aromatic barley wine — Mulled wine. 



CHAPTEE II. — Climatology op United States. 

(Page 97-120.) 

Great variety or climate in United States. — Range of thermometer- 
Influence of winds — Amount of rain and snow — Malaria — Influence of swamps, 
lagoons, marsh lands, alluviums — Great range of thermometer in States east of 
Rocky Mountains — Winter in Maine — Variations of thermometer greater near 
mountains, tropical variations, isothermal lines — Controlling circumstances — 
Oceans, seas, lakes, plains, plateaus, and great mountain ranges — Isothermal 
of 55° — Gradual elevations of plains — Isothermal lines in Rocky Mountains — 
Variations of isothermal on globe's surface — Range of thermometer greater on 
continents than on islands — Western coast, or "cold water coast," of North 
America — Variations of temperature on Pacific coast — Equable climate of Pacific 
coast — Influence of winds lost in crossing western coast range of mountains — 
Valleys of Sacramento and San Joaquin — Maize does not come to perfection on 
Pacific coast — September at San Francisco — Climate of Sierra Nevada Mount- 
ains — Mercury at Holton, Maine — At New Bedford, Mass. — At New York city — 
At Philadelphia — At Baltimore and Washington — At Charleston, S. C. — In 
Florida — At Cincinnati — At St. Louis — At St, Paul, Minn. — At Chicago — Great 
interior plains of North America — At South Pass— Extremes of cold — At Holton, 
Maine — At New Bedford, Mass. — At New York city — At Albany — At Phila- 
delphia — At Washington, Baltimore, and Alexandria — At Charleston, S. C. — At 
New Orleans and Baton Rouge — At Cincinnati — At St. Louis — At Fort Snel- 
ling — At Fort Brown, Texas — At Fort Kearney — At Fort Alamo — Fall of rain — 
Snow — Influence of quantity of rain on climate, health, and disease — Warm 
countries with little or no rain — Ditto with much rain — Temperate climate with 
much rain — Fall of rain on eastern slope of Alleghanies — On western slope — 
Of lake region — West of line drawn from mouth of Rio del Norte fo western 
shores of Lake Superior along Rocky Mountain range — Valley of great Col- 
orado River — Great Salt Lake — West of Sierra Nevada range — Amount of rain 
during spring — During summer — In autumnal months — During winter. 

Surface of United States. — Great interior valley of North America — Influ- 
ence of surface on health and disease — Low districts of South Atlantic States — 
Autumnal fevers — Dry and elevated portions of the country — Ague and fever — 
Regions not subject to malarious diseases — Influence of winds — Heat — Storms, 
hurricanes, and tornadoes — Northers — Snow — Lake storms — Where invalids feel 
best — California as a resort for invalids in summer. 



Xll CONTENTS. 

CHAPTER III.— Mineral Waters. 

(Page 121-129.) 

Mineral waters. — Alkaline — Acidulous — Chalybeate — Aluminous chalybe- 
ate — Sulphurous — Saline — Purging saline — Lime or calcareous — AlkaliBe — 
Disorders they are respectively beneficial in. 



CHAPTER IY.—On Diseases. 

(Page 130-382.) 

Diseases. — Fever — Inflammatory — Mixed — Typhus — 'Bilious fevers — Kemit- 
tent — Yellow fever. 

Inflammation. — Inflammation of brain — Ophthalmia — Inflamed tongue — Of 
tonsils — Mumps — Inflamed larynx — Croup — Catarrh — Bronchitis — Influenza — 
Inflamed lungs — Inflamed pleura^ — Inflamed stomach — Bowels — Peritonaeum — 
Kidney — Liver — Chronic ditto — Bladder inflamed — Urethra ditto — Rheuma- 
tism — Chronic ditto — Gout — Dysentery — Erysipelas — Small-pox — Scarlet 
fever— Disinfecting clothes — Plague — Vesicular fever — Nettle rash — Shingles- 
Blood from nose — From stomach — From bladder and kidneys — Apoplexy — 
Palsy — Partial ditto — Indigestion — Vomiting — -Flatulence — Water brash — Va- 
pors — Epilepsy — -Tetanus — Hiccup — Angina pectoris, or breast pang — Giddi- 
ness — Asthma — Hydrophobia — Colic — Iliac passion — Worms ; parasite upon 
parasite, tape-worm, etc. — Guinea worm — Lead colic — Sea-sickness — Cholera — 
Diarrhea— Diabetes — Consumption — Spitting of blood — Windy swellings — Tym- 
pany — Dropsy. 

Skin diseases.— Chicken pox — Rose rash — Rupia — Tetter, or herpes — Humid 
scall — Chronic eczema — Miliary eruption — Impetigo — Ecthyma — Lichen — Pru- 
rigo — Leprosy — Dry tetter, or baker's or washerwoman's itch — Dandruff — Itch — 
Fish skin — Corns — Warts — Scurvy, land and sea — Itching, or pruritus — Grubs — 
Acne, or copper-nose — Baldness — Hair — Embrocation, etc. — Jaundice — Gall- 
stones — Deaf and dumb — Caniftie appetite — Human rumination — Costiveness — 
Stricture of lower bowel — Gutta serena — Immoderate flow of urine — Strangury — 
Suppression of urine — Granular disease of kidney — Inflamed kidney — Gravel — ■ 
Stone — Cancer — Derbyshire neck — Headache — Toothache, faceache, or tic dol- 
oreux — Sprains — Scalds and burns — Cold, frost-bites, chilblains — Palpitation — 
Angina pectoris — Inflammation of pericardium— Water in ditto — Inflammation 
of heart-j-Diseased valves of ditto — Enlarged heart — Dilated ditto — The blue 
disease — Aneurism — Inflamed veins — Stricture of rectum — Fissure of ditto — 
Prolapse of ditto — Fistula in ano — Gonorrhea — Lues venerea — Enlarged prostate 
gland. 

CHAPTER y.— Diseases of Women. 

(Page 383-466.) 

Diseases op women. — Cancer of breast and womb — Falling down of bladder — 
Ditto of womb — Whites, or fluor albus — Menstruation — Too much, too little- 
Green sickness — Painful periods — Polypus of womb — Cauliflower excrescence 
of womb — Corroding ulcer of womb — Watery discharges from womb — Hydatids— 



CONTENTS. Xlll 

Spinal curvature — Cooper chair-T-Spinal irritation — Hysteria — Asafetida clys- 
ter — Cold douche — Sterility — Inflammation of womb -Chronic ditto — Irritable 
womb — Pregnancy — Longings — Costiveness, exercise, and bathing — The nipples 
and breasts — Signs of pregnancy — Prevention and relief of diseases in preg- 
nancy — Heartburn — Costiveness — Diarrhea — Palpitations and fainting fits — 
Piles — Enlarged veins — Toothache — Salivation — Cramps — Violent movements 
of the child — Distended skin — The bladder — Whites — Pain in side — Headache — 
Miscarriage — Calculation as to labor— Sore nipples after delivery — Excessive 
flow of milk-^Milk abscess — After pains — Weaning — Drying up of milk — In- 
flammation of peritonseum — Puerperal fever — Intestinal irritation — False in- 
flammation of abdomen — Milk fever. 



CHAPTER VI.— Diseases of Children. 

(Page 467-554.) 

Diseases op children. — General observations — Doses of medicines — Effects 
of some medicines on children, and formula — Teething — Scrofula in the neck — 
Treatment of childhood — Iodine baths — Scrofulous ear — Rickets — Atrophy — 
Disease of brain and convulsions — Distinction between water in the head and 
worm fever — Alarming symptoms — The fontanelles — Chronic water in the head — 
The thrush, or inflamed mouth — Diphtheria — Canker of mouth — Mercurial mouth — 
Infantile indigestion — Cholera infantum — Diarrhea — Prolapse of lower bowel — 
Croup — Measles — Cow-pox and vaccination — Ringworm — Still-born children — 
Deformities-^Tongue-tied — Harelip — Blue disease — Trismus — Erysipelas — Ab- 
scesses — Induration of cellular tissue — Jaundice, or yellow gum — Purulent 
opthalmia — Red gum — Swelling of breast — Whooping-cough — Sets of teeth. 



CHAPTER YII. — Poisons, Accidents, Forms of Medicines, and 
Advice to Emigrants, 

(Page 555-610.) 

Poisoning by strong acids. — By strong alkalies — By antimony — By iodine — 
Arsenic — Mercury — Copper — Tin — Zinc — Silver — Nitre — Liver of sulphur — Ba- 
ryta — Phosphorus — Cantharides — Glass — Lead — Acrid plants — Narcotic poi- 
sons — Prussic acid — Mushrooms — Nux vomica — Hemlock, etc. — Alcohol — Putre- 
fying poisons, as putrid meat, serpents, etc. — Accidents — Death from charcoal 
vapor — Fever caused by it — Coal gas, or carbureted hydrogen — Sulphureted 
hydrogen — Drowning — Strangling or hanging — Substances falling into the air- 
pipe — Lightning stroke — Intense cold — Apparent death in new-born infants — 
Substances, etc., in the eyes — Ditto in the ears — Burns and scalds — Sprains-r- 
Bruises or contusions — Cuts and wounds — Dislocations — Ruptures — Fainting 
fits — Lotions — Liniments — Ointments — Mustard poultice — Crotonoil — Blisters — 
Poultices — Aneurisms— Fomentations — Stupes — Antacids — Worm medicines — 
Laxatives and cathartics — Emetics — Cordials, stimulants, and tonics — ^Diluents — 
Diuretics — Diaphoretics and sudorifics — Alteratives — Narcotics and anodynes: — 
Antispasmodics — Astringents — Directions and advice to emigrants — Climates 
for emigrants — Delirium tremens, or drunkard's mania — Medicines to betaken. 



XIV COxVTENTS. 

CHAPTER YIII.— Specific Diseases. 

(Page 611-626.) 
Milk sickness, or sick stomach. — Dr. Drake's views — Observations on the 
nature of the disease — Its origin — Where prevalent — At what seasons — Views 
of Prof. Dickson as to treatment — Chronic cases and their treatment — Phlegma- 
sia dolens, or milk leg — Causes — Symptoms — Cure — Ulcers about the nails — 
Felon, or whitlow — Different varieties of trichina spiralis — History — Descrip- 
tion — Symptoms — Treatment — Accounts of cases. 



CHAPTER IX.— How to Nurse the Sick. 

(Page 627-653.) 
Elements of good nursing little understood. — ^Importance of pure air for 
the sick — Ventilation — Pure water — Efiicient drainage — Cleanliness — Light — 
Effects of noises — Reading to the sick — Effect of beautiful objects on the sick — 
Food for the sick — Manner of preparing — When to give — How much to give — 
Changing the food — Importance of punctuality in administering food — Nutritive 
power of different articles of food for the sick — Beds and bedding — Careful ob- 
servance of the varying conditions of the sick. 



CHAPTER X. — Physical Training and GtYmnastics. 

(Page 654-704.) 
The object of exercise. — Strengthening of muscles — Beauty of form — Pro- 
motion of health — Effect on the brain and nervous system — The due blending 
of out-door exercise and intellectual pursuits — General directions — Best time 
for exercises — Best place for ditto — Clothing to be worn — Exercise to begin 
gently — To iavoid being cooled too quickly — Not to exercise to excess — The 
necessary fitting up — The belt — Training — Directions for — Eesults of — Posi- 
tion — Of the head — Of the body — The limbs — Extension motions — Locomotive 
exercises — The Indian club exercise — The balance step — Without gaining 
ground — Gaing ground by the word forward — Walking — Utility of walking — ■ 
Moderate walking — General mechanism of walking — Slow walk, or march — 
Moderate and quick pace — Feats of walkers — Running — Position in running — 
Action in running — Respiration — Moderate running — Rapid running — Feats in 
running — Leaping — High leap, without a run — High leap, with a run — Feats 
in high leaping — Long leaping — Feats in long leaping — Vaulting — Oblique 
vaulting — Climbing — On the ladder — Inclined board— Upright pole — Mast — 
Slant pole — Horizontal bar — Leaping with a pole^The rope ladder — Upright 
rope — Oblique rope — Level rope — Climbing trees. 



CHAPTER XI. — Physiology and Laws op Life. 

(Page 705-767.) 
On life. — Division of organized beings into animals and vegetables — Of the 
forms peculiar to the organic elements of the animal body, and of the principal 
eombinations of the chemical elements — Of the forces which act in the animal 



CONTENTS. XV 

body — Summary idea of the functions and organs of the bodies of animals, ^and 
of their various degrees of complication— Of the intellectual functions of ani- 
mals — Of food and the digestive process — Sources for the demand of aliment 

Hunger and thirst — Nature and destination of the food of animals Of the 

passage of food along the alimentary canal — Action of the intestinal tube 

Nature of chymification and chylification. 



Glossary of Medical and Scientific Terms 759 

Guide to Diagnosis 771 

Tables of "Weights and Measures 793 

Index 795 



THE AMERICAN 



HOUSEHOLD BOOK OF MEDICINE, 



CHAPTER I. 

ON PREVENTION OF DISEASE BY DIET, EXERCISE, BATHS, ETC, 

There is no place wliich man has made his abode, where nox- 
ious agents which act injuriously on his body have not been pres- 
ent; and these noxious agents invariably disturb the actions of 
its economy, and tend ultimately to destroy life. But, fortunately, 
certain inherent conservative powers exist, which resist the influ- 
ence of these causes of mortality. 

The actual mortality at all times will, therefore, bear a propor- 
tion, regulated by the relative strength of these destructive agents 
and the relative weakness of these conservative powers. There 
are, also, states which tend to enfeeble these resisting or con- 
servative powers — such as the states of parturition, infancy, 
sickness, or those produced by errors in the modes of life — and 
during the prevalence of these states, life may be destroyed by 
causes which would not prove fatal to life under more healthy 
conditions of the system. Were the condition of the body always 
that of health, and the mental state one of enjoyment, the dura- 
tion of life would probably be extended to its utmost limits; but 
this duration is abridged by whatever tends to disturb or over- 
throw the functions of the body, wherefore an improvement of 
an invalid state, or the maintenance of a healthy condition, must 
not only tend to lengthen life, but materially conduce to absolute 
2 (17) 



18 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

enjoyment; and thus the prevention of disease becomes of the 
utmost importance to every one. 

Impressed with these truths, the writer wishes, by a few prac- 
tical observations, to point out the means whereby we may avoid 
many serious errors which are committed during the several 
stages of human life — errors partly caused by the habits which 
civilization has formed, partly by ignorance or thoughtlessness. 

It will not prove unprofitable, therefore, if we advert to these 
causes of disease, which operate often by slow degrees and im- 
perceptibly, and yet which are endowed with great power. And, 
first, of the air we breathe. 

The Air 

we breathe — the atmosphere — ought to be considered with regard 
to its purity, its temperature, its pressure or hygrometric state, 
and its electric condition, as regards the induction of disease. 

Atmospheric air, as far as its chemical components are con-' 
cerned, is the same every-where ; yet it can hold suspended, or in 
solution, many invisible as well as visible efiluvia, such as vari- 
ous gases, unhealthy miasms, and odors. The calorific and colo- 
rific rays of the sun penetrate it, and are again reflected from the 
surface of the earth ; partial rarefaction takes place, and the sea- 
sons influence it. 

The atmospheric air is composed of oxygen and nitrogen, with 
a very small proportion of carbonic acid gas. Before inspiration, 
it consists of 23 parts of oxygen and 77 of nitrogen, and after 
expiration, 3J per cent, of carbonic acid, or, on an average, 27J- 
cubic inches of carbonic acid are evolved from the lungs every 
minute, or about 40,000 cubic inches in 24 hours, weighing nearly 
3 pounds, and containing about 11 ounces of carbon. The diff'er- 
ence between the air before and that after respiration, arises from 
the action of the lungs or respiratory organs upon it, by which 
the oxygen in the respired air is instrumental in removing from 
the blood a great portion of the carbon, and in changing the 
venous or dark bluish-red blood of the veins into the bright red 
arterial blood. 

This arterial blood is destined to maintain in a healthy state all 
the organs and parts of the body, so that, by the action of cer- 
tain organs, certain secretions may be elicited from it to its own 
purification; and when the arterial blood has efi"ected these ob- 



PREVENTION OF DISEASE. 19 

jects, it is again returned by the veins to the heart and lungs, 
there to be acted on by the atmospheric oxygen. How impor- 
tant, then, it becomes that pure air should be supplied in suffi- 
cient quantity. 

A man requires the supply of one-sixth of a cubical foot of 
oxygen from the atmospheric air per minute; but, because of 
the mixture of his breath (expired air) with the air around him, 
he requires, to be safe, the ventilation-supply of two or three 
cubical feet per minute, since it appears that, at each respi- 
ration, 16 cubic inches of air are on an average deteriorated, and 
from 15 to 20 such respirations are taken in a minute, conse- 
quently from 300 to 320 cubic inches of air are each minute 
poisoned (as far as the animal race is concerned) by each indi- 
vidual, and rendered unfit for the support of human life. 

The ultimate elements of animal matter consist of four gase- 
ous bodies — carbon, hydrogen, oxygen, and nitrogen — and by the 
varied union or intermixture of these bodies the proximate ani- 
mal compounds are formed. Into the composition of these latter 
carbon largely enters, the fibrine alone, of which muscles are 
formed, containing more than 53 per cent, of carbon; thus a 
good deal is required. Yet this quantity once attained, nature 
seems to bear with any superfluity very badly; so much so that, if 
carbon exist in the arterial blood beyond its normal healthy pro- 
portion, it acts like a deadly poison, ultimately, and sometimes 
immediately, suspending the functions of the brain, and then the 
action of the lungs. 

Wherefore, to avoid unnecessary accumulation of carbon, every 
one should look to the thorough ventilation of his rooms, both 
for sitting and sleeping in. Windows are the best ventilators ; 
therefore they should be always used as such, both in summer 
and winter; and they should be so arranged that currents of air 
would prevent stagnation in any part of rooms or houses. 

In addition to this, the heated air, which has been vitiated by 
respiration, and which rises to the upper parts of the room, there 
remaining floating about and gradually descending lower and lower 
as the process of vitiation goes on, may be removed continually 
as it forms, by means of an aperture or two made in the upper 
part of the room above the fire-place, and leading into the chim- 
ney flue. These apertures could easily be concealed by a simple 
ornament, which almost any bricklayer could manufacture. Each 



20 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

opening should be covered by one of those self-acting and con- 
stantly-turning ventilators, which are to be got in many places in 
our cities and elsewhere. 

Contrivances to secure a plentiful admission of fresh air are 
also on sale — through the upper panes of the windows, whereby 
a rushing descent of cold air is prevented, and the invalid fur- 
ther secured. 

If these three points were attended to — and this can be done 
at but little expense — many a cold, many a bronchitis, and much 
suffering from disease would infallibly be prevented. 

As to the dwellings of the poorer classes, the writer is de- 
lighted to find that the attention of a humane public has been 
directed to the means of preventing that dreadful packing together 
of human beings in one small room, which has caused so many 
cases of typhus and other dangerous diseases, and has kept up 
foci of infection dangerous to all who reside in their neighbor- 
hood. 

To secure proper ventilation, we ought to effect the introduc- 
tion into the room of four feet, or of from two to three cubical feet 
per minute for each individual in it; and this must be done with- 
out allowing a stream of cold air to affect the body partially, 
more particularly during sleep, when the skin is especially sen- 
sible of frigorific impressions. 

The temperature of the air in rooms should not exceed 58° of 
Fahrenheit, or, in some invalid cases, 60°; but the cooler it is 
the better, so long as no chilling effect is felt. If the external 
temperature be lower than that of the body, the caloric of that 
body is carried off, and is speedily replaced in a healthy individual, 
by an evolution of heat from within, aided by clothing, coverings, 
and exercise. When the external temperature approaches the 
standard heat of the body (about 98°), sweat soon breaks forth, 
and the superfluous heat is carried off by perspiration. An ex- 
ternal temperature of 98° is rather oppressive. But the terms 
hot, warm, and cold are merely relative to our sensations ; and if 
the heat is carried off as fast as it is generated, and no faster, 
no particular sensations are felt. Now this equilibrium is main- 
tained (supposing no extraordinary exertions are made) when the 
thermometer stands at 62° Fahrenheit, or thereabouts. That 
point in the scale may be called temperate ; all degrees above that 
point up to 70° are reckoned warm ; and all above 70°, hot. A 



PREVENTION OF DISEASE. 21 

temperature descending between 60° and 50° is considered cool, 
and every lower degree is cold. 

Too high a temperature causes a relaxation, from which the 
weak and delicate must suffer, so that such persons should avoid 
exercise in summer while the sun is powerful ; and even the 
healthy and robust ought to be cautious in this respect in sultry 
summer weather. The siesta of the Portuguese and Spaniard is 
not a mere luxurious habit; it is essential to health. The cold 
of winter is more healthy than the heat of summer, provided we 
are well clothed, can afford fires, and are strong enough to take 
sufficient exercise. Some of Captain Parry's officers, when near 
the North Pole, walked daily upon the ice when the thermometer 
was 20° below zero ; that is, 50° below freezing. 

The air, in respect of humidity, may bring on a tendency to 
disease. Air too humid relaxes and depresses the nervous sys- 
tem, and too dry air is equally hurtful ; but cold moist air is more 
injurious than cold dry air ; hence night air is generally injurious 
to invalids. Warm moist air may favor dysentery, cholera, and 
fevers. 

When the indication of the hygrometer does not exceed 15°, 
we are directed by our feelings to call it damp ; from 30° to 40°, 
we begin to reckon it dry; from 50° to 60°, very dry; and from 
70° upward, intensely dry. A room is not comfortable, or per- 
haps wholesome, if it has less than 30° of dryness ; but the 
atmosphere of a warm occupied apartment will commonly pro- 
duce an effect of upward of 50°. If an invalid requires a high 
temperature in his rooms, he should have evaporating dishes 
placed in them, to secure a healthy proportion of humidity. But 
sudden variations are very dangerous, and do much mischief. 

The influence of light and of the sun's rays is very conducive 
to health, and to the growth of children. We see this influence 
displayed in the development of certain lower animals. If we 
inclose tadpoles of both frogs and toads in different boxes, some 
of which shall admit light, others exclude it, and place these 
toxes in running water, we shall find that the tadpoles exposed 
to the light will have undergone the change to the perfect form 
of the animal ; while those excluded from the light, though they 
may seem perfectly vigorous, will not have undergone the trans- 
formation, even though they may have increased to double or 
triple their primitive weight. In all those climates where the heat 



22 AMEHICAN HOUSEHOLD BOOK OF MEDICINE. 

renders desirable a state almost approaching to nudity, we shall 
find the development of the frame is early, and the form has 
fewer deviations from the symmetry natural to the race than 
among the' northern nations. Deformity is comparatively rare in 
hot climates, where the surface of the body is much exposed to 
light. The muscular and rounded forms of the Mexicans, Peru- 
vians, the Chaymas of South America, and of the natives in other 
warm climates, are the proofs that light and heat are favorable to 
a healthy development. Heated air must, however, be avoided by 
the invalid, though light should be admitted as much as can be 
borne. Heat expands air, and then it occupies a larger space in 
proportion to its weight; consequently, at each inspiration, less 
air is really breathed, less oxygen obtains access to the blood, 
and the blood is not so well aerated as it ought to be. Accord- 
ingly, we find persons respiring such an atmosphere soon feel 
faint; and in crowded assemblies, or rooms not sufficiently ven- 
tilated, people are often carried out in a fainting state, partly 
from this cause, and partly from the carbonic acid gas floating 
diffused in such an atmosphere ; hence, too, many persons suffer 
from headaches after attending lectures, etc., in ill-ventilated 
rooms. 

To give an idea of the air as a cause of disease, some facts 
may be mentioned which were adduced in 1847, in a very inter- 
esting lecture, by Mr. Toynbee, of England, on ventilation. 

He said disease from atmospheric impurities seemed to be the 
rule, and health the exception. One-fourth of the children born 
in England died before their fifth year ; and out of 49,089 deaths 
in 1846, 14,368 died from diseases of the respiratory organs, 
impure air being the great source of these diseases; and out of 
this number 49,089 people who died in 1846, 22,275 died before 
their fifteenth year, and only 2,241 attained old age. These 
statistics are selected merely as a specimen. Like results will 
uniformly follow similar conditions, and probably but little im- 
provement has taken place since the above facts were published 
to the world, though progress in the right direction is being made. 

The air should be always in motion; stagnant air becomes 
impure, like water. Air always contains much animal and vege- 
table matter, in the form of ova (eggs) of infusoria, and the seeds 
of the lower vegetable organisms. 

But the act of respiration is a great cause of the deterioration 



PREVENTION OF DISEASE. 23 

of air. The air in the lungs is exposed to 170 millions of cells, 
having a surface equal to thirty times that of the body. The 
air ejected after respiration is poisonous. 

A second cause of deterioration is the combustion of lamps, 
gas-lights, candles, etc. A single candle is nearly as injurious to 
the air as a human being, and two fourteen-holed Argand lamps 
consume as much air as eleven human beings. 

A third source of impurity is the vapor, loaded with annual 
matter, given off from the lungs and skin. Each of these parts 
pours out an ounce of fluid every hour ; so that in a church con- 
taining 500 people, twelve gallons of noxious fluid are given off 
in two hours. 

The fourth source is the large quantity of decomposing animal 
and vegetable matter, and the efiiuvia arising ; added to this is 
the difficulty of dispersing such efiiuvia by the wind, in conse- 
quence of the crowded houses, close streets, etc. Dr. Mantell 
found that various classes of infusoria, which he could keep alive 
at Clapham, would not live in London air. And few plants will 
live in London. 

Fever, consumption, scrofula, deafness, and common cold are 
traceable to imperfect ventilation. 

One hundred and twenty thousand people, in England and 
Wales, are slowly dying of phthisis (consumption). 

The propositions submitted to the English government for ven- 
tilation were, that no living, sleeping, or work-room should be less 
than eight feet high, and should contain 144 superficial feet. 

2. That such room should have at least one window, opening 
at its top, and also an open fire-place. 

3. That Arnott's valve should be opened into the chimney at 
top of every such room ; no smell need be feared. In St. 
George's and St. James's Dispensary there was a diminution of 
nearly 800 applicants, owing to improved ventilation, and this 
improvement was owing to the exertions sustained by the Samari- 
tan Fund, attached to the dispensary, to secure ventilation of the 
abodes of the poor in the district. 

4. Every room must have the means of admitting fresh air, 
and all products of combustion should be carried off as they are 
formed. 

5. All churches, schools, theaters, lecture-rooms, work-shops, 
work-houses^ etc.^ should be made to adopt approved and efficient 



24 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

means of ventilation, under the superintendence of an officer of 
health. Much more attention has been paid to these matters in 
Europe than in the United States, partially from the greater 
necessity, growing out of the more crowded condition of towns 
and cities, but particularly because science has been more care- 
fully cultivated. 

As to the atmospheric electrical variations, it is not easy to 
guard against them ; they influence the nervous system rather 
than the vascular, and cause depression of spirits in the absence 
of misfortune, anxiety, or any thing likely to produce such a state 
of feeling. The best way to repel such, injurious influences is to 
invigorate the body by every possible means ; by exercise, proper 
diet, and clothing. The author thinks he has observed that wear- 
ing silk about the body, as, for example, a silk waistcoat, has 
done some good, and he found that some patients of his escaped 
pains in their knees, which looked like those of rheumatism, but 
which either came on, or were always much increased, during 
certain electric atmospherical changes, by wearing silk pocket- 
handkerchiefs round their knees, or by enveloping them in silk. 

The air is the medium of conveyance for endemic and epidemic 
influences. 

The term malaria may be applied to certain emanations from 
the earth, and should possibly be restricted to those vapors or 
miasms which induce endemic diseases, or those arising from local 
influences ; still the origin of epidemical influences may be the 
same as that of endemic, only that the epidemic is borne on the 
wind coming from distant quarters; still, whether distinct or not, 
there is no doubt that, though the Asiatic cholera is an epidemic 
disease, yet the liability to its visitation is evidently connected 
with local circumstances, which either assist in developing the 
activity of its mysterious germs, or, at all events, exert an 
attractive influence over them. 

Endemic means in or among a people, applying to diseases 
peculiar to a certain class of persons or country. Thus, ague is 
endemic in marshy places, and scurvy to sea-faring people. 
Epidemic means upon the people, as if an atmosphere descended 
and involved a large number at once. It applies to diseases, 
contagious or otherwise, which attack many people at the same 
season and in the same place. Thus, putrid fevers, plague, dys- 
entery, Asiatic cholera, influenza, etc., are epidemic. Asiatic 



PKEVENTION OF DISEASE. 25 

cholera is produced by an animal poison, and does not fall upon 
a whole people at once, but begins in particular parts of towns 
or cities, and in sparse populations dies out by attacking a few 
persons, leaving those not connected with them unaffected. 

The malaria is a specific poison, and it produces specific effects 
upon the human body. It is not simply bad air or impure air ; 
it is a widely-spread poison, and the mildest form of fever it 
gives rise to is ague. In hot climates it occasions remittent, and 
even continued fevers, often of bad type or character. These 
gaseous emanations proceed from the earth's surface ; they are 
aeriform, or are conveyed in the atmosphere, though they are 
imperceptible to our senses, nor do we know any thing of their 
chemical or physical qualities. 

Malaria requires a certain temperature for its production. It 
is seldom traceable beyond the 56th degree of north latitude, and 
60 degrees of Fahrenheit is the temperature said to be requisite 
for it to exist. The nearer we approach the equator the more 
virulent are the effects; but while in England it gives rise to 
intermittents (agues), in Spain and the Mediterranean remittent 
fevers, as well as agues, arise from it, and in the West Indies 
continued fevers. To this degree of temperature a certain degree 
of humidity must, however, be added. 

Agues are accordingly endemic in Holland; and in Italy, the 
Pontine Marshes, and the district called the Maremma are cele- 
brated for the ravages committed by it; so that a portion of 
country stretching for thirty leagues along the shores of the 
Mediterranean, and ten or twelve leagues broad, is rendered 
dangerous and almost uninhabitable by it. America and newly 
settled countries are obnoxious to it. In India it is pestiferous 
to man and beast; and in May, after the rains have ceased in 
certain districts, and the extreme heat comes on, the very mon- 
keys and tigers go up to the hills, and do not return till October. 
The decomposition of vegetable or animal remains, or of both, has 
been assigned as the originator of this poison ; but this is not so. 
The putrefying animal and vegetable remains may co-exist with, 
but do not originate the poison. These emanations proceed from 
parts of the earth's surface that have been flooded and then dried. 
The higher the temperature, and the quicker the drying process, 
the more virulent the poison. When parts previously dangerous 
are entirely flooded over, the danger ceases. 



26 AMERICxiN HOUSEHOLD BOOK OF MEDICINE. 

In the West Indies, on the higher grounds, agues occur ; lower 
down, remittents, while in the lowest and hottest parts continued 
fevers arise. 

Strangers are more readily affected than those habituated, but 
the black-skinned negro is always exempt from all attacks. All 
malarious districts are more dangerous at night, and to sleep at 
night in the open air in such districts would be to invite an attack ; 
neither should the morning air be breathed too soon in such 
places. 

The malaria loves the ground, and combines or becomes entan- 
gled with fogs ; therefore persons should sleep in the highest 
rooms, for the poison does not rise high in the atmosphere. Lon- 
don fogs never rise more than 240 feet above the level of the sea 
at low water, and as the Norwood hills are 390 feet above the 
same level, the air on those hills is likely to be pure and invigor- 
ating. It is carried by the wind like a heavy fog or vapor, and 
these points should all be attended to by the traveler through 
malarious districts, or by those who settle in hot climates. Another 
singularity of malaria is, that the vapors lose their noxious prop- 
erties by passing over even a small surface of water. Perhaps 
they are absorbed by it. And many a sailor might escape an 
attack of fever by sleeping on board his ship instead of staying 
on shore. Malaria is attracted by, and adheres to, the foliage of 
lofty trees, so that it would be very dangerous to sleep under 
them ; yet this peculiarity proves a protection to many who live 
to leeward of an interposing screen or belt of trees. In Guiana, 
where large trees abound, the settlers live, fearlessly and unhurt, 
close to the most pestiferous marshes, so long as they are thus 
protected by trees. 

Lastly, numerous facts have proved that cultivation of the soil, 
draining, etc., have prevented the generation of malaria. 

Persons should leave such dangerous localities, if they can, and 
travelers should stay as short a time in them as possible ; but if 
necessary to take the risk of such influences, they should live as 
well as they can in moderation, and take a daily preventive dose 
of quinine during the seasons of danger. No precaution should 
be neglected to prevent an attack from malaria, since repeated 
fevers of this kind produce ultimately the most serious and 
dangerous consequences. As to epidemics, all that can be done 
in prevention is, to take care that all offensive materials shall be 



PREVENTION OF DISEASE. 27 

removed from our dwellings and homesteads; that drains and 
sewers shall be in constant, efficient, and full operation ; that 
cleanliness be observed, and as plentiful a supply of pure air 
obtained as possible. 

Unhealthy miasms creep up the sewers, ascend sinks in kitchens 
and water-closets, all Avhich should be kept closed by self-acting 
valves, and the sinks well corked or stopped; for in this way both 
rich and poor are endangered, and may suffer; and the epidemic 
influence meeting with the miasms, seems to be immediately en- 
dowed with most deleterious power.* 

The Mental Affections as Causes of Disease. 

The influence of mental impressions on the circulation of the 
body are illustrated by the act of blushing, by the instantaneous 
pallor of fear, or by the swelling red face of anger and the quick- 
ened breathing of surprise and joy. The sighing and pain in the 
chest which follow sorrow and other depressing emotions, display 
the power of the mind over the respiratory functions ; palpitations, 
tremors, faltering speech, and increase of muscular power, which 
are caused by the various emotions, give us evidence of the power 
posssessed by the mind over our muscles ; and the tears which 
flow from sympathy show us its influeuce over the glands, while 
the secretions are affected also in a very extreme degree. 

The first condition of a healthy action of the brain is a sound 
original constitution ; the second is a due supply of properly 
oxygenated blood ; and the third is the regular exercise of its 
functions. If the brain be not sound originally, there is only the 
greater occasion for care, inasmuch as less will be sufficient to 
excite derangement of function in a brgfin so constituted than in 
one of sound congenital structure. 

The second condition is essential; for if the arterial blood 
within the cranium (skull) be not sufficiently oxygenated (pure), 
the mental functions will become impaired or altogether cease; 
and if it be over-oxygenated, it will be too much stimulated. 
Living in an impure air, breathing or living in ill-ventilated 
places, or total want or deficiency of nourishing food, will, in course 
of time, affect the blood in this way of under-oxygenation, pro- 



* See the chapter on the Climatology of the United States, and also that on 
Intermitting and Remitting Fevers, for further information on these subjects. 



28 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

ducing languor, headache, hysteric, and other nervous symptoms. 
On the other hand, a diet too nourishing or abundant -will, also, 
like too poor and scanty a diet, affect the blood through the stom- 
ach, and, by preventing the proper assimilation of the food, 
cause the transmission to the brain of blood not sufficiently stim- 
ulating. 

The third condition is the most important of all, for the brain 
must be duly exercised, but not overtasked; and yet how often 
is this overtasking met within the present day! The brain obeys 
the same laws as other organs of the body, so far as its peculiar 
exercise is concerned. If it is allowed to be inactive, the intel- 
lectual functions will suffer in proportion to the inactivity, and 
act slowly and fee*bly. After a time, it reacts upon the body, and 
may induce indigestion, hypochondriasis, hysteria, and other nerv- 
ous symptoms. The ^^ dolee far niente" existence of the South- 
ron is well known; but, as applied to mind or body, no more 
pernicious mode of life than such a one can be adopted, destruct- 
ive equally and alike of both mind and body. It may at first 
be pleasant, but its consequences are destructive. Let every one 
resist the first temptation from this insidious foe as he would avoid 
an overwhelming torrent. 

But here, in America, we are more in danger of overtasking 
the brain than of the reverse ; and, to begin with children, there 
is no doubt that too much intellectual exertion is demanded from 
them. In the earlier years of life, nature is busily at work to 
build up, in strength and soundness, the various organs of the 
human body, leaving intellect to the last, as the Corinthian cap- 
ital to life's column. 

We should content ourselves with allowing the senses and per- 
ceptive powers of children to acquire information, and their in- 
tellect will thus educate itself. By so doing we do not interfere 
with the processes concerned in the growth of the body; but if 
we go beyond this, and exact from the immature brain what 
ought only to be expected from the maturer one, we shall cer- 
tainly be originators and witnesses of a breakdown, which will 
be doubly melancholy if there have been previous promises of 
intellectual brilliancy. 

For too rapid development of the brain entails premature dis- 
solution; and premature mental attainments are frequently as 
destructive of life as a too rapid growth of the body. Philip 



PREVENTION OF DISEASE. 29 

Barettier was an instance of this. He was born in January, 
1724. French was his mother-tongue, with some words of High 
Dutch; but in consequence of his father talking Latin to him, 
it became as familiar to him as his native idiom; so that, with- 
out knowing the rules of grammar, he, at four years of age, 
talked French to his mother, Latin to his father, and High Dutch 
to the maid or neighboring children, and without mixing or con- 
founding the respective languages. In his fifth year he acquired 
Greek in like manner. • Before he was six years of age he en- 
tered on Hebrew ; at nine, he composed a dictionary of Hebrew 
words, with philological observations. With these he intermixed 
the study of the Chaldaic, Syriac, and Arabic ; and, having *iii 
his possession a pair of globes just at this time, in eight or ten 
days he was able to solve all the problems on them. He after- 
ward studied medals, inscriptions, antiquities, metaphysics, and 
experimental philosophy. This blazing meteor of genius died in 
October, 1740, aged only 19 years, 8 months, and 10 days. 
The vulgar saying, ''He's too clever to live," is founded upon 
observation. 

In other cases these early specimens of superior intellect are 
sometimes followed by a state of imbecility. Antiochus tells us 
that Hermogenes, who was a celebrated rhetorician at 14 years 
of age, was ignorant in the extreme at the age of 24. 

Overstudy produces its victims continually, and we read of 
Cicero being dyspeptic, of PUny's life being rendered miserable 
by heartburn, of Bayle dying a martyr to excessive application, 
and of Sir Isaac Newton falling into a deep melancholy for a 
long time, which deprived him of the power of thinking. Great 
students generally have extreme susceptibility of nerves and 
much irritability of temper, and their digestive powers are not 
only much impaired, but often nearly altogether overturned. 

Such men are unintentional suicides, and little good can be 
expected from remonstrances; but in the case of children, we 
have their management in our OAvn hands, and much beneficial 
training of their minds can be effected by directing their opening 
powers of observation, by teaching them to discriminate accu- 
rately, and by pleasantly and in the way of amusement leading 
them on from the knowledge of effects to that of causes. Chil- 
dren will thus readily and rapidly acquire information, who, if 
they had been pinned down to learn, and, parrot-like, to repeat 



30 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

abstract propositions of grammar, etc., would appear the veriest 
dunces that ever disappointed a parent's hopes. 

The author alludes here to young children only, for a time will 
arrive when a sugar-plum system of education must be aban- 
doned, and the business of education entered on in a serious and 
rational manner, alone worthy of its vast importance. 

We read of the celebrated philosophe-moraliste, Michel de 
Montaigne, who imparted to the French language an energy 
which it did not possess before, that he acquired a knowledge 
of the Latin by having a person to reside with him who spoke 
nothing else ; and Montaigne, in this easy way, learned to speak 
it*as a vernacular tongue, with tolerable fluency and freedom, at 
the age of six. Greek was also taught him as a sort of diver- 
sion. By means equally gentle and attractive, he was insensibly 
led to acquire some knowledge of science, and without forcing 
his inclination or imposing the necessity of application, his habits 
were formed, and his powers agreeably exercised. 

Many other persons could be enumerated who have, as chil- 
dren, even drank somewhat deep at the fountain of learning, 
while it seemed as if they were only slaking a thirst for amuse- 
ment. 

The system of teaching at schools has been hitherto such that 
but scanty regulations are provided for the well-being of the 
body, the cramming with learning and accomplishments being 
the chief, if not the only, object aimed at. It is thus teachers 
fail of success ; their true policy consists in a regulated alterna- 
tion of work and play. Who that has ever been a hard student 
has not known, after some hours of severe study, both the great 
relief derived from a walk taken with a mind in repose, and the 
freshened energy with which study can again be applied to, en- 
abling him to conquer the difficulties of the very same subject 
which before had appeared nearly insurmountable. 

In the education of young women too little attention is given to 
subdue the imaginative faculty and to moderate sensibility; on 
the contrary, they are generally fostered. It is thus there is too 
often laid the foundation of hysterical, hypochondriacal, and 
even maniacal diseases. The truly frivolous occupations of 
fashionable Hfe, and that affected refinement which debars natural 
and active exercise, also nourish these tendencies, and become 
predisposing causes of every form of nervous disease, endowing 



PREVENTION OF DISEASE. SI 

slight causes of disease with undue power. To regulate the pas- 
sions should be our constant study, for the exciting passions, when 
in excess, give rise both to spasms and convulsions, while the de- 
pressing passions relax the whole muscular system. The influ- 
ence of education and of a due regulation of the passions is 
incalculably great. 

Sleep. 

Both mind and body require diurnal rest for the healthy exer- 
cise of their functions. The fatigued muscle must recover itself, 
and the overwrought mind would at length break down, if sleep 
did not enable it to cease, for a time, from all excitement and 
activity. The most complete repose is, of course, the most salu- 
tary; and to secure this, both body and mind should have been 
exercised during the day, just so far as to avoid painful fatigue 
or exhaustion; the circulation should not have been excited by 
deep study, intense thought, nor by any stimulant, for some time 
previous to retiring to rest. Late and copious suppers should be 
avoided; the head not kept too warm; while the feet, especially 
if they are disposed to be too cold, as in many females, should 
be brought to a healthy temperature, before getting into bed. An 
iodine warm foot-bath, with a little cyanuret of potass in it to 
prevent itching, will be found serviceable. Lastly, the cares of 
the day should be put off with the clothes. 

The quantum of sleep varies with the circumstances of an in- 
dividual, some requiring more than others. One author tells us 
that the oldest man he ever personally knew, a man aged one 
hundred and eight, informed him that he rarely exceeded four 
hours of sleep in a single night at any period of his life ; but 
from six to eight hours may be regarded as the proportion for a 
healthy adult. Too much sleep favors apoplexy and coma, and 
too little wears out the brain and nervous system, and might in- 
duce a suspension or impairment of their functions^. 

The bedrooms should be spacious, or, at least, well ventilated; 
their temperature should be moderate, and not subject to any 
great diminution throughout the night. The bedsteads should 
have few hangings of furniture, merely at the head; and feather- 
beds are too relaxing. The bedclothes should be well aired 
every day ; those who perspire freely during sleep should change 
their flannel under-garments for some lighter covering. 



32 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Exercise. 

It is no new thing to extol the virtues of exercise. Ferrandus, 
in the seventh century, calls it a spur of a dull, sleepy nature, 
the comforter of the members, cure of infirmity, death of diseases, 
destruction of all mischiefs and vices. And another author says 
idleness enervates the frame, labor fortifies it; the first tends to 
produce premature old age, the last to perpetuate adolescence. 

The amount of exertion should never exceed that healthy de- 
gree whereby a grateful sense of activity and comfort is produced; 
for otherwise exhaustion and much discomfort will ensue. It must 
be proportionate to and kept within the powers of the individual. 
The exercise should be taken daily, and, if feasible, in the open, 
dry air ; and the invalid, who at first may be able to walk only a 
short distance, should not exceed that distance for some time, 
but augment it gradually and daily. In the case of females, the 
muscles should have full scope ; and all ligatures, every thing that 
presses upon or confines any part of the body, such as tight stays, 
etc., should be avoided. An anatomist informs us that Mademoi- 
selle Leblanc, a young French milliner, remarkable for the small- 
ness of her waist, died at Edinburgh, an early victim of con- 
sumption; and he found that those portions of the muscles in 
the belly, back, and loins, which had been subjected to the highly- 
strained pressure of the corset during life, were reduced to the 
consistence of a soft, flaccid cellular tissue, faintly sheeted with 
muscular fiber. Yet, notwithstanding the now generally-acknowl- 
edged bad effects of tight stays, or of any thing which impedes 
the free action of the muscles and the breathing, the practice will 
still continue with all those silly females who are ambitious to 
appear wasp-waisted ; and parents should vigilantly guard against 
it. Even the infant, at its very entrance into life, does not es- 
cape; for the nurse, in dressing it, bandages it up so tightly as 
to compress its chest, prevent it from expanding properly, thus 
favoring the formations of the chicken-breast in children pre- 
disposed to consumption and scrofula. Pressure, too, is some- 
times unintentionally exercised in the case of rapidly-growing 
girls, by their clothes becoming too small; wherefore they should 
be examined from time to time, or otherwise a pernicious habit 
is thus early originated of first bearing and then requiring arti- 
ficial pressure and support. 



PREVENTION OF DISEASE. 49 

India-rubber bottle, stuffed with wool, and affixed to a cane handle. 
In this way we can imitate the action of the natural douche baths 
of Aix, in Savoy, and some other continental watering-places, 
which combine the influence of heat and percussion. A tempera- 
ture of 160° is readily borne in douching. 

Patients who are suffering from deep-seated pains, or from 
chronic rheumatism, should be douched and percussed in this 
manner for half or three-quarters of an hour at a time, and they 
should afterward be placed in bed between blankets, to encourage 
sweating. In stiff, enlarged, and painful joints, the greatest ad- 
vantage has resulted from this douching; but it must be perse- 
vered in for two or three months, or longer, before the crutches 
can be laid aside. In certain cases of fevers, and in a state 
threatening inflammation of the brain, the cold douche is to be 
tried. The first effects are not pleasing, but relief is so quickly 
experienced, that the patient generally requests a repetition. 

The Air-pump Vapor Bath will confer relief and benefit in 
cases of gout, rheumatism, contracted joints, and other chronic 
ailments, where the preceding have failed. This bath must pos- 
sess considerable power as a remedy in obstinate cases, since it 
may stand in the place of a very efficacious fomentation and dry 
cupping. It first conveys the soothing vapor to the part affected, 
and then, by exhausting the air, a vacuum is formed, or the at- 
mospheric pressure is taken off so far as to allow of a temporary 
expansion of the vessels, by which operations a probability is 
afforded of removing obstructions. 

To recapitulate : We should avoid cold bathing when the habit 
of body is generally full ; in diseases attended with discharges of 
blood, with quick pulse, and an excited system; in all kinds of 
acute inflammation; in diseases of the breast, attended with short 
dry coughs — -difficulty of breathing; in gout and rheumatism; 
in diseases of the skin — during a state of pregnancy ; in palsy, 
and in many cases of indigestion, though in other cases of 
stomach disorders, where reaction soon follows the first shock, it 
may do good. 

The Shower Bath (beginning with tepid water) is, in most cases, 
preferable to bathing in cold water, since the sudden contact of 
the water may be repeated or modified at pleasure. The head 
and chest are secured from danger by receiving the first shock 
of the water, and the blood propelled toward the legs, so that 
4 



50 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

the head and chest feel comparatively hght and unincumbered, 
while all the pressure of the water Avhich occurs in the cold bath 
is taken off. 

One caution with respect to cold bathing should here be given, 
and it applies also to drinking cold water as well. It is that we 
may bathe fearlessly in cold water, although we may be unusually 
heated, provided the heat is steady and permanent. "Increased 
heat, whether from exercise or other causes, does not forbid a 
cold bath, provided the cause of the increased heat remain in 
action, that there is no local disease, and that the body 'is not 
fatigued and fast losing its heat. But if a person be already ex- 
hausted and weakened by exercise; if he be sweating and rapidly 
parting with his heat, and especially if the exercise be over, and* 
he remain at rest immediately after and during the application 
of the cold, then it becomes highly perilous, and likely to pro- 
duce internal mischief." The application of cold, then, is dan- 
gerous, not when the body is hot, but when the body is cooling 
after being heated. 

In this way sudden deaths have been occasioned by men who have 
been working very hard, unto some exhaustion and great sweat- 
ing, and who have suddenly drank large quantities of cold water. 

When dangerous symptoms arise, either from bathing in cold 
water injudiciously, or from drinking cold water when heated 
and exhausted, the remedies are warmth immediately to the pit 
of the stomach, and laudanum in free doses. 

The wet-footed or wet-skinned sportsman need not fear danger 
so long as he continues in active exercise ; nor need the bather 
who has walked to the cold bath wait till he cool ere he plunges 
in ; neither should the young lady, after heating herself by danc- 
ing for many hours of the night in the ball-room wait in the hall 
to cool before she gets into her carriage, but let her go directly 
home and into bed as soon as she can ; while the gentlemen who 
are returning from balls or parties in a heated state should not 
wait to get cool, but put on their great-coats and walk briskly 
home to bed. 

"The heat which is preternaturally accumulated by exercise 
is held with little tenacity, is dissipated by profuse perspiration, 
and is speedily lost when to this perspiration is added a state of 
rest after fatigue." Under such circumstances cold is prejudicial. 

The tepid bath is admissible and useful in almost all cases — • 



PREVENTION OF DISEASE. 61 

during infancy, pregnancy, and especially old age. Women who 
dread tedious and painful labors should have a tepid bath three, 
four, or five months before their expected time. During puberty 
the tepid bath may be very useful, though it is not advisable to 
allow of sea-bathing for about two years during that period. 

This tepid bath is of service in indigestion, in liver complaints, 
in debility and extreme weakness, in contractions of joints, and 
in skin diseases. From 10 to 1 P. M., that is, after breakfast, is 
the best time, and gentle exercise is to be taken after staying in 
the bath from twenty to sixty minutes. 

The warm bath is employed in acute rheumatism, inflammation 
of the abdominal organs, of the kidneys, bladder, and womb ; in 
suppression of urine; in the convulsions from teething and other 
causes ; in skin diseases, slight palsy, green sickness, St. Yitus's 
dance; in convulsive and other spasmodic affections; in costive- 
ness, intestinal obstruction, and in debility, with nervous irrita- 
tion. It agrees with weak, delicate, nervous women who have 
sufi'ered miscarriages from sexual weakness, etc. 

When perspiration is to be elicited, the evening — ten minutes 
before going to bed — is the time for the bath. When not in- 
tended to excite perspiration, any time from an hour after break- 
fast till dinner will be proper, when fifteen to twenty minutes or 
thereabouts should be the time for staying in the bath; but this 
may be as the patient likes. Gentle exercise in the open air (if 
weather permit) should not be neglected after each bath. 

The Vapor Bath is indicated where the warm bath is useful. 
It excites an increased action in the superficial arteries, and thus 
diminishes the blood in the interior of the body; wherefore it 
is of service in inflammatory fevers, inflamed bowels or stomach; 
in liver complaints, dropsy; in scrofula, gravel, palsy, and gout, 
as well as in rheumatic afi'ections. Use it in the morning, or 
before dinner, for ten or fifteen minutes, or even double that 
time. In all cases of bathing, the body should be properly dried 
and rubbed. 

We may here introduce a few observations on the system called 
Hydropathy; and the word, taken in its strict etymological ac- 
ceptation, is apposite enough, for it means water diseases, or 
diseases caused by water. Some of the clearer-sighted of its 
advocates now call it the water-cure system. 

The credulity and ignorance of the general mass of the pub- 



52 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

lie is in no instance more clearly exemplified than in its eager 
acceptance of any system of quackery which should be boldly 
put forward as infallible, and which possesses, at the same time, 
a few features of plausibility to argue upon. 

To the words credulity and ignorance it may be objected that 
the favorers of all the successive systems of quackery have not 
been confined to the low, poorer, and ignorant classes of man- 
kind, but many of them have been men of intellectual eminence, 
and men both wealthy and titled. To style such persons ignorant 
seems startling and indefensible; yet all such persons are ignorant 
with respect to medicine and to the sciences upon a knowledge 
of which it is built up, an adequate acquaintance with which can 
only be acquired by many years' study of anatomy, physiology, 
pathology, and its cognates. The only remedy lies in opening 
the eyes of the public to the grossness of the delusions which, 
in matters relatmg to medicine, they practice upon themselves, 
or allow others to practice upon them. Surely, it will be ad- 
mitted that a knowledge of the nature of the disease under which 
a patient labors is an indispensable preliminary to the safe and 
proper management of his case; and if, in attempting to arrive 
at this knowledge, so many sources of difiiculty and fallacy 
await even the best informed medical practitioner — he who is fur- 
nished with all the means of avoiding and overcoming them which 
the accumulated experience of ages has been able to discover or 
invent — the prudent man may hesitate before he admits the belief 
that these difficulties can be overcome by persons of no scientific 
instruction, and who professedly reject all aid from the observa- 
tions or experience of others, he may well pause to consider 
whether the discrimination of such a person can be with safety 
relied on, and whether the freedom of such a person from doubt 
or uncertainty in diagnosis may not arise from the rash pre- 
sumptuousness of ignorance rather than from the reasonable con- 
fidence which knowledge is calculated to inspire. Foster, in his 
^'Essays on Decision of Character," says, that a confident de- 
cision on any subject may arise either from knowing all that 
is to be known of that subject, or from complete and total igno- 
rance. In which category of the two we ought to place the 
presumptuous, unprincipled quack hardly need be told. 

The writer of these lines has seen the rise and fall of many 
a quackish medicine and system; and one of the first examples 



PREVENTION OF DISEASE. 53 

of the power of the imagination over the body, upon which the 
quack most relies for success, was afforded in reading the history 
of Perkins's Metallic Tractors. Dr. Haygarth was resolved to 
test the said tractors on some suitable case in the hospital which 
he attended ; and, as a preliminary, he tested the natural tempera- 
ture of the patient by putting the bulb of the thermometer under 
the man's tongue. The latter, knowing the tractors were going 
to be tried, thought the thermometer was the tractor, and cried 
out immediately that his pain (rheumatic or neuralgic) was gone. 
Upon this, Dr. Haygarth continued to apply the thermometer 
daily; while on other patients wooden tractors, made exactly like 
the metallic tractors in outward semblance, were tried, though 
there was no metal in them. The wooden and the metallic both 
acted alike; that is, similar effects were produced. 

To the metallic tractors succeeded other systems of quackery, 
all enjoying more or less of patronage from certain classes for a 
time, until we arrive at these days of patent pills, Vegetarianism, 
Eclecticism, Homeopathy, and Hydropathy. 

With respect to this last, there is no doubt but that, as an aux- 
iliary to medical treatment, and under the superintendence of 
medical practitioners, it may yet take its place, and, with judi- 
cious management and restriction, may do much good. But the 
true hydropathist relies on water, and water alone, for the cure of 
all diseases; and thus many a credulous man, who can afford to 
pay well, will be made to drink water to excess, to live on a most 
wretched diet, in some cases; to be bandaged up like a mummy, 
and to be pumped upon till the breath is well-nigh beaten out 
of him. Still, there were some cases in which good was, no doubt, 
effected ; and can we not give a guess how such good may have 
arisen, or how it may be rationally accounted for? It is an un- 
doubted fact that, however impatient sick persons are under the 
regimen and restrictions of diet imposed by the professionally 
educated adviser, they no sooner place themselves under the care 
of a quack, than the directions as to diet, in quantity and quality, 
and as to other matters, are cheerfully submitted to. The author 
was told of a gentleman of leisure who consulted, many years 
ago, the most fashionable physician of his day. The gentleman 
had lost flesh, and complained of the usual symptoms of indiges- 
tion. When his doctor began to restrict the diet, the patient in- 
duced him to allow a diet almost as full as that he was used to — 



54 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

soup, fish, meat, game, and pastry. The patient getting no better, 
then applied to the then leading Homeopath. What did he do? 
He made him rise at half-past seven in the morning, instead 
of half-past ten or eleven, and take an early walk; he allowed 
him only a very restricted diet,, with orders to avoid certain 
drinks, odors, etc. In a few weeks this gentleman's stomach 
recovered its powers, and he recovered his flesh. This was a 
cure, said to have been eifected by the globules of homeopathy, 
after the most eminent physician of the day had failed. Yet such 
a case wanted only Dr. Common Sense to prescribe, and no one 
else. 

As a parallel case, and to show the good effects of exercise as 
an auxiliary to treatment by the mineral waters, the writer read 
of a patient who received the greatest possible benefit from some 
mineral waters. After a few years he tried them again, but they 
totally failed, until he discovered that he had omitted the regu- 
lated exercise which had been ordered during his first visit. So 
shall we find it happens in hydropathy, that much of the good 
effected arises not so much from the water as from the walks, 
the rides, the mountain scenery, to ascend which, as we have 
seen, requires blood-purifying exertions of the muscles; and in 
the case of the mind-shattered student, author, or merchant, from 
the mind having left its cares behind. 

The water itself must do good, by cleansing the skin, by eliciting 
perspiration, and a healthy state of its pores ; and when it is tried 
in proper cases, no objection can be raised against it. These 
restrictions would not suit the hydropathic enthusiast, who insists 
that his system will cure all diseases, if persevered in long enough. 
Such persons either do not or will not see how very unreasona- 
ble and unphilosophic it is to make the skin an outlet for all dis- 
eases, when nature has established many outlets of secretion, as 
those who have read the preceding observations on secretion 
have seen. 

In diseases of the liver, the chief outlet is through the bowels ; 
in those of the kidneys, through the urine. 

No hydropathist used to be contented with any thing less than 
the appearance of an ill-conditioned eruption on the skin, which 
was looked upon as critical, and as a sign that the disease was 
thus thrown out of the system ; but which, it is more likely, was 
reall}^ and truly a manifestation of the skin having been stimulated 



PREVENTION OF DISEASE. 55 

to the extent of disease, and of the blood having been at length 
pat into a more watery condition than it should possess in health. 
For there is a law in the human animal economy, which has 
already been glanced at, namely, that one organ will often act 
vicariously (in place of another) for another. Thus, in hot cli- 
mates, less carbon is abstracted from the blood, during respiration, 
than would be consistent ultimately with health, and then both 
the skin and the liver act vicariously; and copious perspiration, 
with bihous diarrheas, keep the blood in a state of purity for a 
time ; but in thus doing more duty than nature meant them, to 
perform, their power of action becomes diminished, and disuse 
is set up at last. 

We should make use of the skin, then, as an auxiliary to our 
■otber means of treating diseases, but not as the sole dependence. 

We will, now give a short description of the mode in which 
the water is applied, mentioning some of the diseases in which 
the hydropathists recommend them to be used. 

The means employed in the water-cure are the cold bath, the 
sudorific (sweating) process, the shallow bath, the wet sheet, the 
sitz bath, the wet bandage, the douche, and the foot bath. 

In the sweating process, the patient is undressed and enveloped 
in a large blanket; the legs are stretched out, and the arms kept 
close to the body; the blanket is then wound round the body as 
tight as possible, and turned under the feet; over this, another 
blanket or two should be wound round, and over all a small 
feather-bed is placed; a counterpane and a sheet are spread over 
all. As soon as perspiration appears, the windows are opened, 
and a wine-glassful of cold water is allowed every half-hour, if 
desired. If the head begins to ache, a wet cloth should be ap- 
plied to the forehead and temples. The cold bath is then taken, 
if the patient seems strong enough to secure reaction. The 
sweating process should precede the cold bath, for the perspira- 
tion relieves the internal parts from fullness, and the patient is 
then better able to support the shock of the cold bath. After 
all the baths, the patient is dried, not with towels, but by a sheet 
thrown "round his body, drying the whole body at once. 

The Shallow Bath is long enough to sit or lie down in, or to 
sit down in with legs extended, and should contain six or eicjht 

7 O 

inches or more of water; and the water may be either tepid or 
cold, the tepid being preferable where there is local inflammation 



56 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

or fever, and the cold when there is general debility. Patients sit 
in this bath, and should be rubbed well all over, and cold water 
may also be poured on them. Few cases of debility will not be 
benefited by this remedy; and chronic inflammations will be either 
relieved or cured by it. The bath is to last from one to ten 
minutes, according to the judgment of the prescriber. 

The Sitz Bath is our hip bath; it is usually about eighteen 
inches in diameter, and contains about two gallons of water, cold 
or tepid. The patient should sit in it every day, or twice or 
even thrice a day, for from ten to thirty minutes. It is of great 
benefit in disorders of the abdomen*, head, or pelvis (hips). In 
weak bowels, torpid hver, in irregular periods, it should be tried. 
This and the foot bath relieve the head, remove congestions 
(partial fullness of vessels) and lower the pulse. 

The Foot Bath is oblong and shallow, contains about two inches 
of water, or even one inch only. The time of sitting in the bath 
is about eight or ten minutes, and the feet should be rubbed in 
the bath, and rubbed docj afterward, when a brisk half-hour's walk 
should be taken. This is useful for head affections, blood to the 
head, headache, eye diseases, and cold feet. 

The Douche is prescribed to invigorate weak parts, and con- 
sists of a fall of water from a height varying from tw^elve to 
eighteen feet, or more, and the stream should be about the thick- 
ness of a man's wrist. The undressed patient exposes one mem- 
ber or part of the body, then another, to the stream for two, 
three, or five, minutes, taking care that the chest and head shall 
not receive the stream and shock. 

TJie Splash Bath. — A small stool is placed in a shallow bath; 
upon this the patient sits, and is well splashed by the attendant. 

V/'et Spinal Friction. — The patient, undressed, stands, or sits 
upon a stool, upright in a bath, while the attendant rubs his back 
with a towel dipped every now and then in cold water. One or 
two minutes should not be exceeded in doing this. 

Wet Friction. — Similar to the foregoing, only the towel is 
wrung dry, and the patient rubs the front, while the attendant 
rubs the back of the body for one, two, or more minutes, and 
the patient is then wrapped in the drying sheet and dried. 

Under-hlanJcet Friction. — The patient lies down upon a mat- 
tress, covered by a single blanket ; a second is thrown over him. 
The bathman dips a towel into cold water, wrings it out more or 



PREVENTION OF DISEASE. 57 

less, and having wrapped it round his hand and wrist, introduces 
his hand beneath the upper blanket, and rubs the patient's body, 
back and front, and the extremities, for from two to ten minutes. 
The towel may be dipped into water as many times as may be 
deemed necessary. This is applicable to cases of debility, where 
exercise is impossible. 

' Wash-down — of three towels, as it is called. The patient 
stands in an empty tub or bath, beside which stands a pail of 
cold water, with two coarse towels soaking in it. The attendant 
places one of the towels on the patient's head, loaded as it is 
with water, who seizes it, and rubs himself rapidly with it (?ver 
face, throat, shoulders, chest, body, and legs, and lets it drop into 
the water, when the attendant, who has been doing in like man- 
ner with the patient's back, puts another charged towel on the 
head, and so on to a third. The patient is then rubbed in the 
drying-sheet, dressed, and sent out to walk. 

Upstanding, Dripping or JRuhbing Sheet. — The patient stands 
upon the floor, or in a tub or bath. A sheet of convenient size 
is then dipped in cold water, and as much of the loose sheet is 
wrung out of it as will keep it from dripping at the bottom. This 
is thrown over the patient, head and all, from behind, like a cloak, 
and it should be long enough to reach down to the ankles, and 
wide enough to enable the patient to seize those loose parts of 
the sheet, which will hang in front, and use them as towels. 
With those loose portions of the sheet, the patient must actively 
and rapidly rub himself from his face to his feet ; the attendant 
rubbing him well, meanwhile, behind, not with the folds of the 
sheet, but he rubs the sheet itself with his hand, as the sheet 
clings to the body, and without moving the sheet. This is done 
for two or three minutes, and then the dry sheet is put on, and 
the patient rubbed till he is dry. 

This may be done in the recumbent position, while lying on a 
blanket, thrown over a mattress, where the patient is too weak to 
stand. Priessnitz used this in Asiatic cholera. 

Can or Pail Douche. — The vessels, one or more, as ordered, 
are thrown over the patient suddenly, before and behind, and 
thrown with some force; then the drying-sheet. 

The Douche, for one or two minutes, protecting the head with 
the hands, is very delightful. 

Weei-sheet Packing. — This is said to be the crowning glory of 



58' AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

the water-cure; and Dr. Johnson speaks of it as a discovery 
which, before fifty years are past, will place its author, in the 
world's estimation, upon a par with the discoverers of vaccina- 
tion and of the circulation of the blood, and as a remedy which 
reduces inflammation as speedily as the lancet, but is followed 
by none of that debility which results from loss of blood, and as 
combining the soothing powers of opium with the tonic power 
of quinine, while it slowly extracts from the blood the poisons 
of gout and rheumatism. It is serviceable in both acute and 
chronic disease, and approaches nearer to a panacea than any 
drug or medicinal apphcation. 

The process is the following: Place a pillow upon a mattress, 
and upon the mattress, and partly over the pillow, spread two 
blankets; upon the blankets lay a sheet which has been dipped 
in cold water, and then wrung out as dry as possible by two 
persons' strength. Upon this damp sheet the patient lies down 
undressed, with his head reposing on the pillow. The sheet is 
then folded tightly round the body, and the blankets are folded 
round the sheet. Then several blankets, one after the other, 
are laid upon the patient, and tucked well in on all sides around 
him, so that he lies completely incased, and not able to stir hand 
or foot. A linen napkin is interposed between the chin and the 
blankets, to prevent irritation. Thus he is to lie for fifteen to 
thirty minutes, or even an hour. Then he is taken out of the 
packing, and immediately submitted to the shallow bath, drip- 
ping-sheet, wash-down, or pail douche. Then the drying-sheet 
is wrapped round him, and he is sent out to take exercise, or he 
is ordered to bed, according to circumstances. This is the wet- 
sheet packing. 

The Blanket Packing is performed without any sheet, but the 
patient lies on a mattress, covered by two blankets. There is 
some art required to cover the body with the blankets by turning 
down the corner under the chin, and tucking it over the opposite 
side of the body; then the rest of the blanket is brought over 
evenly and tucked under the opposite side, until the blanket is 
made to tuck in and under the feet and ankles. The opposite 
side is covered in like manner, and then a couple more blankets 
are put on. The windows may noAV be opened, and weak black 
tea given, if necessary; and if the head get uncomfortable, a 
wet towel may be applied to it. Perspiration will appear sooner 



PREVENTION OF DISEASE. 59 

or later, but sometimes not before two, three, or four hours have 
elapsed. After the packing, some form of cold bath should be 
taken. 

The Half Wet-sheet Packing, in which the sheet extends from 
the armpits to the knees, the arms not being included. 

Fro7it and Back Towel Packing is by means of a towel wrung 
out of a cold bath, applied to chest and back. 

The Rot Air Bath, by means of a spirit lamp placed under a 
cane-bottomed chair or stool, on which the patient sits enveloped 
in blankets ; but the vapor bath, already described, is more pow- 
erful, and is w^ell adapted for the poor. By this latter. Dr. 
Johnson says he has cured diseases which had defied all ordinary 
remedies, and which promised to embitter the whole future exist- 
ence of the sufFererSo 

Then there are the head shallow bath, the head douche, head 
plunge, eye or ear shallow bath, eye douche, mouth-washing; 
the running sitz bath, in which water is continually running in 
and out; the fountain sitz, where the patient sits upon a stool 
with a central aperture, through which a jet of water rises; the 
hand shallow bath and handful bath; the elbow, the arm shallow, 
arm plunge, and arm immersion; the foot and leg shallow and 
full baths; the leg plunge and leg immersion, local douches, and 
friction with wet hands, all which need no particular detail of 
directions. 

These baths are employed to reduce heat and the quickness 
of the pulse, and to quiet nervous agitation. In fevers and in- 
flammations, the wet-sheet packing is to be preferred ; but in 
convulsions, and most other nervous affections, the shallow baths 
and its congeners are proper. A slow and gentle reaction fol- 
lows the wet-sheet packing, and this is preferable to a sudden 
one, in the treatment of fevers and inflammations ; but the shallow 
bath and affusion are appropriate to nervous affections, for the 
reason that renders them inappropriate in the treatment of fevers 
and inflammations. 

The same author thus describes the effects of the wet-sheet 
packing: A considerable quantity of heat is at once abstracted, 
the person feels chilly, but in a short time the powers of the 
system reproduce an equivalent amount of heat, and a genial 
warmth. The action of the heart and arteries is depressed, a soft 
langour steals over the frame, and a disposition to sleep. This 



60 AMERICxVN HOUSEHOLD BOOK OF MEDICINE. 

process, if unduly prolonged, would be enervating and debilita- 
ting; but it is inexpressibly soothing and restorative in feverish 
and many other conditions of the system. 

Tlie Wet Bandages, or UmschlagSy which, by-the-bye, are not pe- 
culiar to the hydropathic system, since they have been in use by 
the medical profession for centuries, are useful in most local 
complaints, and in constipation. They are made of coarse linen, 
of any convenient width, and are employed by the hydropathist 
in gout, rheumatism, ulceration, swellings, sprains, and weakness 
of the limbs. They should be worn all day, and sometimes 
during the night. ^ In active inflammation, the linen is dipped in 
the coldest water, wrung out, applied to the part, and taken 
away and replaced as soon as it becomes warm ; but when there 
is no inflammation the wrung-out cloth is applied, and a dry 
bandage placed over it, so as to promote perspiration. 

When we want to apply a bandage round the body, it should 
be three or four yards long, and twelve or thirteen inches broad, 
of which one yard is to be dipped in cold water, wrung out, and 
then laid over the stomach and bowels, the remaining yards being 
wound tightly over it, and tied on one side. In sprains, bruises, 
and in rheumatic and gouty joints, the wet bandage must be cov- 
ered with a dry one. 

The rationale of the beneficial efi'ects of the water-cure system 
is based by the hydropathists upon the researches of Liebig. 
Into these we can not enter for want of room, further than in 
a way of summary, extracted from a lecture delivered by Dr. 
Johnson. A person, in an average state of health, submitted 
for a minute and a half to that process which has been termed 
taking the shallow bath, imparts to the water sufiicient heat to 
raise a gallon of water thirty degrees Fahrenheit; that is, to raise 
a gallon of water from sixty to ninety degrees. Of course this 
quantity of heat is abstracted from the body, and must be re- 
placed, and it is replaced; for the patient is actually warmer 
when he gets out than he was vv^hen he got into the bath. Whence 
comes this newly generated heat? The heat of the body is pro- 
duced in the same way as the heat of an ordinary fire; that is 
to say, animals are kept warm by a process of combustion, by 
the combustion, or oxydation, of very minute particles of their 
own bodies, and this combustion takes place throughout the 
whole fabric. As fast as heat is abstracted, so is combustion 



PEEVENTION OF DISEASE. 61 

increased by increased action of the vital powers. After a cold 
bath the fires burn more quickly, and an increased consumption 
of fuel occurs. Now the body itself supplies this fuel, and the 
body would, consequently, waste if it w^ere not repaired with equal 
rapidity, and the solids destroyed are thus replaced instantly 
from the blood which solidifies on the vacant spot. The fluid 
blood becomes reduced in quantity, but, at the same time, a sense 
of hunger and an augmented digestive power are developed, and 
an increased quantity of food is sought for, digested, and con- 
verted into healthy blood; so that the blood increases in volume, 
and the body becomes more bulky and more powerful. 

The internal use of water has not been adverted to, but the 
drinking quantities of cold water has been practiced for ages, 
and long before the water-cure system was talked of. It acts 
by diluting the blood- but many can not drink cold water at all — 
it chills too much. 

From this somewhat lengthened description of hydropathy, it 
will be conjectured that the author thinks much good may be 
derived from a judicious application of it, under men profes- 
sionally educated; otherwise, hydropathy may become an engine 
of mischief instead of an instrument of good. 

One need not wonder at the opposition which the system first 
encountered, for it was said to perform cures almost miraculous; 
and the books first written on the subject were written in a 
tone of desperate exaggeration, of blind and obstinate one- 
sidedness, and evidently with an ad captandum object, which 
took advantage both of the supp^essio veri and the admissio falsi 
(suppressing unfavorable truth, and admitting favorable false- 
hoods) ; w^hereas, in all our investigations, our object should be 
truth, and not the defense of a system. 

That it may be useful in many cases there can be no doubt, 
but those cases must be duly selected by men competent, from 
their previous studies, to form a correct judgment as to the 
nature of the case and the process which ought to be employed. 
Priessnitz certainly performed some extraordinary cures, but he 
very often failed to benefit his patients, because of his violent 
and extreme measures. Nor must we forget that his sanatormm, 
being close to mountains, was favorable to his success by afi"ord- 
ing air, exercise, and variety to persons in a state of confident 
hope that they were about to be cured. Air, exercise, and 



62 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

variety, combined with early rising, a regulated diet, and the 
absence of ball-room parties and concerts, will always effect much 
good without any other help. 

It is worthy of notice that one of the advocates of hydropathy 
(Mr. Claridge), who was an early, a bitter, and an uncompro- 
mising opponent of doctors and of drugs, traveling over many 
places to promulge hydropathic doctrines, has himself been 
obliged to apply to one of the much-abused doctors, and, more- 
over, to take one of the decried drugs; and the writer wals in- 
formed by a physician, now dead, that a celebrated gentleman, 
who had written a very poetical eulogium on the water-cure 
treatment, which he had undergone in a particular place, was 
obliged to or did apply to him, very shortly afterward, on account 
of the very same ailment which had been said or supposed to be 
cured by the water-cure system. In the latter instance, tem- 
porary good had probably been effected by mountain air, early 
rising, keeping the skin in order, and by having nothing exciting 
or disquieting to think of. 

It is one great objection to the water-cure, that it is attainable 
by the wealthy and idle only. The poor man is precluded — first, 
because he has not the money necessary; and, secondly, because 
he can not spare the time necessary to effectually obey the di- 
rections, and to perform what is indispensable. 

Food and Diet. 

We have before said that all vital action* is accompanied by a 
certain expenditure of the various substances which compose the 
textures of the animal body, and which are found in the excre- 
tions of the body — the lungs carrying off a large proportion of 
the carbon and hydrogen, the kidneys almost the whole of the 
nitrogen, together with a lo.rge proportion of the inorganic salts ; 
and the alvine evacuations contain a mixture of carbon, nitrogen, 
and inorganic matter. Food, therefore, is required of such nu- 
tritious character and in such quantity as will yield an amount 
of carbon, nitrogen, water, and inorganic salts sufiicient to repair 
the waste of the body. If this be not done, the excretions (out- 
goings) exceed the incomings, and the person must lose flesh. 

But there are two vital processes going on which require sup- 
plies of suitable aliment for their support. The first is the one 
alluded to in the foregoing paragraphs ; namely, the waste of the 



PREVENTION OF DISEASE. 63 

tissues. The other is the function of respiration, on the support 
of which depends the temperature of the body. 
' The first is accompanied by the expenditure of a great quantity 
of nitrogen, which is thrown out by the kidneys; the second, by 
a large consumption of carbon, which appears in the exhalations 
from the lungs. 

Articles which are best suited for the repair of the tissues 
abound in nitrogen, and are called nitrogenous articles of diet; 
those which supply material for respiration, and abound in carbon, 
are called non-nitrogenous articles of diet. Nitrogenized foods, 
or plastic elements of nutrition, are vegetable fibrine, vegetable 
albumen, and caseine, animal flesh and blood. 

Non-nitrogenized foods, or elements of respiration, are, fat, 
starch, gum, cane-sugar, grape-sugar, sugar-of-milk, pectine, 
basssorine, wine, beer, and spirits. 

The animal tissues contain nitrogen as one of their essential 
constituents. The non-nitrogenized foods alone are incapable of 
supporting animal life, since they can not supply the animal tis- 
sues; whej^efore, if these assertions be correct, it follows that 
the food of all animals must contain nitrogenized materials.. It 
is easy to see how man can be nourished by the blood and the 
flesh of animals; that blood and. that flesh are, in all respects, 
identical with their own. But those animals have been of the 
herbivorous and graminivorous kind; and, as they ate no flesh, 
which contains the nitrogen, it was long an enigma how they 
obtained the nitrogen whereof their muscles, etc., consisted. But 
the riddle has been solved with certainty, by the discovery made 
by Baron Liebig, that all such parts of plants as serve for food 
to animals contain certain constituents, which constitute nitro- 
genized forms of nutriment, called vegetable fibrine, vegetable 
albumen, and vegetable caseine. These constituents have been 
obtained from carbonic acid, water, and ammonia; that is, from 
the constituents of the atmosphere, with the addition of sulphur, 
and of certain constituents of the crust of the earth. 

These three vegetable constituents are identical with, and 
resemble, in every respect, their analogues, animal fibrine, albu- 
men, and caseine. Albumen, of which we have a familiar ex- 
ample in the white of the egg, is the form into which all the 
substances which contribute to the nutrition of the animal tissues 
or textures must be converted before they are absorbed. Albu- 



64 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

men exists as a chief and characteristic ingredient in the fluid 
part of human blood; but it^ can not be made use of as the 
material for the production of tissue, until it has undergone con- 
siderable alteration, by which fibrine is formed. This converted 
albumen, or fibrine, is not to be met with in the first products 
of digestion, but it is gradually formed at the expense of the 
albumen which these supply; and as the fibrine flows to every 
part, in and with the blood, and is deposited to form new text- 
ures, it is reformed from the albumen, which is elaborated from 
the food. Fibrine, then, is something intermediate between albu- 
men and solid tissue ; and it has been very appositely termed by 
the French chair coulante, or liquid flesh. By the act of nutri- 
tion, it is converted into new fibers, new cells, etc., in connection 
with those already or previously formed; and the waste, or dead 
matter, which is being constantly set free in the action of the 
several organs, is conveyed away. Part of this waste matter is 
got rid of by uniting with oxygen in the lungs during breathing, 
and is thrown out in the form of carbonic acid and water, while 
the other parts are got rid of by excretion, which separates the 
injurious substances from the blood, and pours them, in a fluid 
form, into channels by which they are conveyed out of the body. 
The respiration, besides purifying the blood, introduces oxygen, 
and thus conduces to the maintenance of the animal temperature. 
Thus admirably have arrangements been made by the Omniscient 
Creator of all. 

But we must now proceed to the cookery of food. 

Foods possessing an organized texture, as animal flesh and 
amylaceous substances (starchy or farinaceous matters, as Ice- 
land moss, tapioca, potato, arrow-root, bread-fruit, barley-meal, 
oatmeal, wheat flour, rye-meal, rice, peas, beans), require to be 
cooked, previous to use. The oyster is an exception, which is 
more digestible raw than cooked. Apples, pears, and some other 
fruits are also exceptions. 

By salting, smoking, and pickling, the animal textures become 
harder and more indigestible ; wherefore they become unfitted for 
dyspeptics, excepting only bacon, which occasionally proves more 
digestible than the fresh fat. Sausages, cured meats, and decayed 
animal substances, when kept too long, often act like poisons. 
We can not, in our present knowledge, explain why, except by 
resorting to hypothesis. 



PREVENTION OF DISEASE. 65 

Boiling is the operation best suited to the sick, the dyspeptic, 
and the convalescent. In boiling vegetable matter, we effect the 
solution of the gummy and saccharine substances, and the ex- 
pulsion of volatile oil, in part or altogether; and this last opera- 
tion renders some vegetables milder, less irritating, and more 
nutritious than if eaten raw, as in onions, leeks, garlic, shallots. 
By boiling, starch grains are ruptured and partially dissolved, 
rendering them more digestible ; for the outer laminas, or layers, 
of the starch grain are thicker, more cohesive, and less easily 
digested than the inner. The albuminous and fibrinous liquids 
are colgulated, as in the potato. It may here be remarked that 
the potato is a solanum, and contains solanine, a narcotic poison, 
in some parts of the plant; yet if any be contained in the potato 
itself, it must be destroyed by the heat in boiling, as in the cas- 
sava-root. Nauche asserts that the infusion or decoction of po- 
tatoes promotes the renal and biliary secretions, and affects the 
nervous system, which would seem to prove, if true, that the 
water in which potatoes are boiled, extracts or destroys some 
noxious matter. 

In boiling meat, its fibrine becomes harder, which fibrine, being 
insoluble in water, contributes nothing to the liquid. The albu- 
men of the meat is partly solid, partly liquid. The latter is 
coagulated by the boiling water, and a portion of it is soluble, 
and contained in the broth. 

The coloring matter of the blood colors the water, but forms 
flocculi ultimately, which float on the top as scum; the cellular 
tissue, the bones, and tendons yield gelatine, or jelly; the fatty 
matters melt and float on the top, unless inclosed in the cells of 
the meat; the nervous matter is carried off in part during the 
process. 

Overboiling proves injurious in some cases, as in eggs. An 
egg boiled so as to coagulate the white, or albumen, and leave 
the yolk fluid, is nutritive, and moderately easy of digestion ; but 
a raw egg will often cause diarrhea ; wherefore, it has been given 
in jaundice and obstructed liver; and an overboiled egg is very 
indigestible by most people, and still more so when fried in pan- 
cakes, fritters, and omelettes. Gelatinous foods are less digesti- 
ble and nutritious when overboiled. Leafy food, as greens, 
cabbage, etc., require to be well boiled, or they will be indiges- 
tible. 

5 • 



6b AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Roasting is the next best process of cooking for the invalid. 
It splits and renders soluble starch grains; it coagulates the 
vegetable albunaen ; it deprives flesh of part of its water, liquefies 
the fat, which partially escapes; it coagulates the albumen, and 
corrugates the fibrine. Roasting, as in boiling, does not effect 
any change in the nitrogenous part. 

Roasted meat should be neither under nor overdone. The 
notion that underdone meat is the most nourishing is afi error, 
for the juice, which is more abundant in the undressed meat, is 
almost entirely aqueous, and can possess very slightly nutritive 
qualities. By prolonged roasting the water of the juice is^vapo- 
rated, and the nutritive matter remains almost entirely in the 
cooked meat, the soHd or dry matter of which is identical with 
that of raw meat. Well-done meat has a little less, both of fat 
and water, than under-dressed meat, and it is more digestible. 
Roasting differs from boiling, in not extracting the gelatine. 

Broiling effects the same changes in meat as roasting, only 
more rapidly; it scorches the outside of meat, while the inside 
retains its juciness. Broiled meat, like roasted meat, is more 
savory than boiled meat, though less fitted for very delicate 
stomachs; but, nevertheless, a well-broiled mutton-chop, cleared 
of fat and grease, is generally a most unobjectionable dish for 
the dyspeptic. 

Baking is an objectionable process. Its general effects are 
analogous to those of roasting and boiling. But meat so cooked 
is much impregnated with empyreumatic oil, and is, therefore, un- 
fitted for delicate stomachs. Baked potatoes are less nutritive 
than boiled ones. 

The dyspeptic must avoid all baked foods, except, perhaps, 
baked amylaceous puddings, such as puddings of sago, tapioca, 
arrow-root, rice, etc. 

Frying is the most objectionable of all the processes of cook- 
ing, fried foods being more indigestible by the invalid than when 
cooked by any other process. The influence of heat on fatty 
substances effects various chemical changes in them, whereby 
they are rendered more difficult of digestion and more obnoxious 
to the stomach. The heat is applied in the form or through the 
medium of boiling oil or fat. Now, fixed oils give off, while boil- 
ing, carbonic acid, a little inflammable vapor, and an acrid volatile 
oil, and the fatty acids of the oils are, in part, set free. Cooked 



PREVENTION OF DISEASE. 67 

butter proves more obnoxious to the stomach than cooked olive 
oil, for probably the acrid volatile acids of the butter ^re, under 
the influence of the heat, set free. 

The invalid, the convalescent, and the dyspeptic must, there- 
fore, avoid this method of cookery; and must abstain from the 
use of eggs, omelettes, pancakes, fritters, fish, livers, and other 
dishes cooked by frying. 

Times of Eating. 

The time required for the digestion of the food, by the healthy 
stomach, varies from one to three hours and a half, or thereabout ; 
and after the stomach has been empty some time, a shorter or a 
longer time, according to circumstances of age, exercise, etc., a 
desire for more food may arise, and until this hunger or desire 
for food arises, fresh food ought not to be introduced into the 
stomach, or we shall impair digestion in the end. 

The length of interval between each meal must vary with the 
age. As, for instance, children, whose organs of breathing are 
active, require to be more frequently fed than grown-up persons ; 
so do persons who labor hard or take much exercise. A bird, 
with its active respiration, deprived of food, dies on the third 
day; a serpent, with its sluggish breathing, can live without food 
three months or longer. 

The carnivorous animals are better with only one meal every 
twenty-four hours. 

Three meals a day, breakfast, dinner, and supper, are the suffi- 
cient and usual number, though in fashionable and hotel life 
luncheon and tea are frequently added. Between two full meals 
six or seven hours should intervene. 

Breakfast is better taken very soon after rising, for, in the 
morning, the system is susceptible of morbific causes, and espe- 
cially the delicate and invalid. An early breakfast of coffee has 
prevented the spread of fever in some bad climates. This should 
be the general rule, though there may be exceptions, where per-, 
sons feel better for a good brisk walk before breakfasting. 

The Luncheon is only admissible when the interval 'between 
breakfast and dinner is very prolonged, or when the food taken 
at breakfast is very trifling, as we so often see in the case of 
ladies. With those who dine late, a luncheon, about four or five 



68 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

hours after breakfast, is both useful and necessary. It is a sort 
of light dinner. 

Dinner should be taken j&ve or six hours after breakfast; but 
if the breakfast has been very light, or the exercise great, food 
may be required sooner. 

Tea, two or three hours after dinner, is an agreeable and re- 
freshing meal, for, by that time, the food should have left the 
stomach, and the chyle should be entering the appropriate chan- 
nels, when dilution is not only agreeable, but called for. 

Supper is unnecessary to those who dine late, but to those who 
dine early, who take much exercise, or labor hard after dinner, 
supper is decidedly necessary. 

At meals we should eat slowly, masticate thoroughly, and cease 
as soon as we feel satisfied, resolutely refusing to eat more. Our 
diet should not be too varied at one meal, for that leads to over- 
burdening of the stomach, because the palate is stimulated, and 
the appetite provoked beyond its natural extent. After a full 
meal we should rest, but not sleep, for one or two hours, by which 
time the food will have been nearly all digested; and then moderate 
exercise is grateful, and demanded by nature, though the necessi- 
ties of busy life in our new world seem to preclude people in gen- 
eral from devoting so much time to rest or moderate exercise. 

The quantity of food required depends upon varying circum- 
stances — age, labor, etc.; but, on looking around us, how pain- 
ful it is to observe that while many of the poorer classes of so- 
ciety are unable, in times of dearness and scarcity, to purchase 
food enough to keep them from a lingering starvation, or, as in 
Ireland, from a rapid process of starvation, we find thousands of 
the wealthier classes, who actually eat themselves into premature 
graves, especially in the cities. 

As school-boys, we have read of and wondered at the gluttony 
and extravagance of some of the Roman emperors — of Vitellius, 
with his four huge ' daily meals, with his accustomed vomit to 
enable him to eat the more. Yet, it is to be feared that, to a 
certain extent, and excepting this custom, modern parallels 
might be found. "Such men seem, like moral incendiaries, so 
to ventilate the lamp of life, as to fire away part of their micro- 
cosm with destructive inflammation, while others replenish it 
sparingly with the oil of temperance, and to them the flame burns 
steadily and shines to the end." 



PEEVENTION OF DISEASE. 69 

"It is not within the compass of human power to protract, in 
any sensible degree, the period of old age, properly so called; 
that is, the stage of decrepitude — ^ the sans teeth, sans eyes, sans 
taste, sans every thing.' In this stage of existence, the physical 
changes that successively take place clog, day by day, the vital 
machinery until it can no longer play. In a space of time, fixed 
within narrow limits, the flame of life must necessarily expire, 
for the processes that feed it fail. But thou^, when fully come, 
the term of old age can not be extended, the coming of the time 
may be postponed. To the preceding stage an indefinite num- 
ber of years may be added; and this is a fact of deepest interest 
to human nature." — Dr. S. Smith. 

If we are to believe in the accuracy of Virey, the Englishman 
consumes more meat than the inhabitants of other civilized coun- 
tries. " The annual consumption of meat for each inhabitant of 
Spain," says Yirey in his Hygiene Philosophique, is 22 lbs.; in 
France, 36 lbs. ; in Paris, 86 lbs. ; in Great Britain, 92 lbs. ; and 
in London, 143 lbs.!" 

There is a disorder, caused by repletion, which abridges hun- 
dreds and hundreds of persons of many years of their lives, and 
hurries them into the grave just at the very time when they think 
they are beginning to enjoy life. The practical physician is 
continually meeting with such cases. The symptoms are at first 
insidious, and occur in persons who have passed their fortieth or 
forty-fifth year. They come to cities, perhaps from the coun- 
try, in a state of perfect health and activity, but with nothing 
in their pockets; they engage in business, encounter competi- 
tion, work hard, and attain success after some twenty or twenty- 
five years. Now they ride where they used to walk; they ea.t 
and sleep well, and take little exercise. The stomach becomes 
of aldermanic proportions, perhaps, and the great veins within 
it become literally gorged with blood. The progress to destruc- 
tion is sometimes checked by some inflammation being set up, 
demanding bleeding, purging, and lowering; or piles bleed freely, 
and a fresh lease of life, though probably a short one, is obtained ; 
the same destructive habits are renewed, and, all at once, a fatal 
attack of apoplexy occurs. These cases are those comprised 
under the recent term of the pendulous abdomen or belly. 

The writer, some years ago, lost a friend in this way, who was 
of middle age, and of full plethoric habit. The writer told him 



70 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

that he must both eat less and take more exercise, or take physic 
or be sick. The patient took purging physic, which seemed to 
give temporary relief. Then a violent inflammation of the leg 
occurred, which lowered him for a very considerable time, during 
which no physiq was required. When he recovered, and the old- 
enemy was re-appearing, one of his sons advised him, during 
the writer's absence, to consult an eminent physician, %ho had 
a crotchet about l^ent gout. The poor fellow was treated ac- 
cordingly with tonics, etc., and not long afterward the writer 
was summoned to his deathbed, for outraged nature could bear 
no more, and a fatal attack of apoplexy had supervened. 

Now, this instance is not related to terrify, but to warn; and 
many need the warning — aye, will continue to need it. And 
when any gentlemen, of the age and habits described, begin to 
find their stomachs bowing out; when in the morning they wake 
with thick, furred, yellow, or yellowish-brown tongues, the breath 
foul ; when they feel a sort of nausea in their throats, which will 
hardly bear the touch of the tooth-brush a little too near the 
gullet without exciting vomiting; when the stools are irregular 
or too scanty; when to these slighter signs are added disturbed 
digestion, with a full pulse, perhaps throbbing templeSj perhaps 
giddiness and a flushed face, let them beware in time, and act 
accordingly ; and, if they do, they may, indeed, have to check 
the gratification of their appetites, but, in return, they will prob- 
ably live and enjoy life many years longer than they would oth- 
erwise have done. 

Such persons should diminish the quantity of their food — 
should take two, three, or four active purgatives, at three or 
four days' interval, and should wear an abdominal belt ; while 
they should take exercise pretty freely. 

In such cases as these, the wet bandages — called by the Ger- 
man hydropathists umschlags — might be of service after the full- 
ness of the abdomen has been reduced sufiiciently. But this pre- 
liminary is indispensable. 

We will now advert cursorily to the digestibility of difi'erent 
articles of diet, which will bring under notice the nitrogenous 
and non-nitrogenous articles, or those destined to keep up the 
function of respiration and the animal temperature. Animal food 
is more easily digested, and contains a greater proportion of 
nutriment, in a given bulk, than does farinaceous or herbaceous 



PREVENTION OF DISEASE. 71 

food; but it is more heating and stimulating. Farinaceous food, 
as bread, rice, arrowroot, sago, or gruel, is also rapidly assimi- 
lated, and proves less exciting than animal food; but it affords 
less stimulous to the muscular coat of the stomach, and causes 
4ess vascular action in the mucous coat, wherefore its long-con- 
tinued use impairs digestion and weakens the stomach, while it, 
at the same time, becomes a very suitable food where irritation 
in the stomach exists. Milk is digested as easily almost as far- 
inaceous food, and is nearly as unstimulating. 

Other kinds of vegetables are slow in undergoing digestion, 
and their fibrous portion passes out of the stomach, unchanged, 
into the bowels, there causing irritation often. They excite less, 
but they support less, and they often give rise to much acidity 
and flatulency. 

Liquid food. — Soup is slow of digestion, often gives rise to 
acidity, and hence is unfit for dyspeptics. The fluid part must 
be first absorbed; wherefore the author always advises soup to 
be taken with bread crumbs, thickly thrown in, or else the soup 
must be thickened with rice, etc. 

The fat of the body may be introduced into the system ready 
formed, or it may be derived from the digestion of starch, sugar, 
and analogous substances. 

Man is an omnivorous animal, and requires both animal and 
vegetable food. Several alimentary principles are found in both 
animal and vegetable foods; but the nutritive principles of ani- 
mal food are intermixed with a smaller quantity of non-nutritive 
substances than those of vegetable. 

Yegetable food requires for its digestion more time, and prob- 
ably greater pov/er of the gastric organs, than animal food, and 
it is more apt to create flatulency and sourness. The lactic 
acid, or milk acid, is the source of this sourness, so trouble- 
some to dyspeptics. This acid is so called because it exists in 
sour milk; and it is formed when various vegetable substances 
become sour, as when oatmeal is left in a large quantity of 
water. The alimentary principles which yield it are sugar, dex- 
trine, (that is, starch gum,) and gum, and all these substances 
consist, chemically, of two atoms of carbon with ten, eleven, 
twelve, or fourteen atoms of water; but in order to convert them 
into this acid, an organic nitrogenized substance, which has been 
modified by exposure to the air, is necessary. Its influence is a 



72 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

kind of ferment. Diastase, caseine, and animal membrane, (as 
that of the stomach,) when they have been exposed to the air, 
act as ferments. Thus sugary substances and milk produce lac- 
tic acid in a weak stomach; so will bread and beer, through the 
dextrine they possess. Oatmeal and the potato cause sourness 
by forming first dextrine, then lactic acid. Some of the fatty 
acids disagree often. The butyric acid from butter is very irri- 
tating. The facihty with which butter becomes rancid depends 
on the presence of caseine, from which it is necessary to sepa- 
rate it if we want to preserve it; and this is done usually by 
fusion. New bread, rolls, fancy bread, cakes, rich plum cakes, 
and hot buttered toast should be prohibited. jGrood loaf bread, 
one day old, is the best; it may be toasted, and with even a 
little butter on it. When the ordinary loaf disagrees, an unfer- 
mented bread will often be of great service. It may be made in 
either of the two following ways : Of wheaten flour, 7 lbs. ; carbon- 
ate of soda, 350 to 500 grains; water, 2f pints; muriatic acid, from 
420 to 560 drops, or enough. Or this: Flour, 1 lb.; sesquicar- 
bonate of soda, 40 grains; cold water, j- pint, or enough; mu- 
riatic acid, 50 minims; powdered white sugar, a tea-spoonful. 

Mix well the soda, sugar, and flour, in a large basin, by means 
of a wooden spoon. Gradually add the water, with which the 
acid has been previously mixed, stirring constantly, so as to form 
an intimate mixture very speedily; divide into two loaves, and 
put them into a quick oven immediately. If any soda should 
escape the action of the acid, a yellow spot becomes visible, 
which is only unsightly. 

Moldy bread (bread covered with fungi) has proved injurious. 
Rich cakes owe their indigestibility to the butter or lard which 
they contain ; but cakes may be made by the unfermented pro- 
cess, like the bread. In this unfermented bread and cakes, there 
is a risk of the acetous fermentation, or of the decomposition 
of gluten. 

All pastry is bad, from the injurious influence of heat on all 
oily, fatty substances — butter especially. 

As to puddings, the most digestible is one made with bread, 
biscuit, and boiled flour. Batter pudding is not so easily digested, 
and suet pudding is highly objectionable ; so are pancakes. 

Of butcher's meat, mutton and beef stand first, boiled, roasted, 
or fried, and moderately well dressed. Young meats (lamb and 



PREVENTION OF DISEASE. 73 

veal) are less digestible and nutritive than the older meats. Pork 
is not to be eaten by the dyspeptic, though pickled pork and 
bacon may. 

Venison is highly digestible, but it is also highly stimulating. 
Rabbit's flesh is light, and easy of digestion. 

Of birds, the white-fleshed, such as the common fowl, are best 
fitted for dyspeptics and invalids, because such meat is readily 
digestible, nutritious, and not too stimulating. They should be 
cooked by boiling, and eaten without melted butter. Game is 
richer and more stimulating, as the pheasant and partridge. The 
duck and goose, and all whose flesh is permeated with fat, are 
more difficult of digestion. 

The white fish (as the sole and whiting) are light and digesti- 
ble, and are well adapted for invalids and convalescents. They* 
should be boiled, and eaten without melted butter. The whiting 
has been called the chicken of the sea. Salmon, eels, herrings, 
sprats, etc., abound in oil, and are objectionable on that account. 
Cured fish of all kinds are to be avoided. 

Shell fish, too, are difficult of digestion, and should be avoided, 
excepting oysters. 

Mealy potatoes, if well boiled or steamed, are digestible readily; 
but the cabbage tribe are uncertain, proving, even when well 
cooked — which it should always be — very indigestible, causing 
flatulence, etc. 

Peas and beans, especially when old, are difficult of digestion, 
and they may cause fiatulence; the older the worse they are. 

The walnut, filbert, and almond contain oil, and are indigestible. 

The grapes are the safest of the fleshy fruits. Apples and 
pears must be roasted. Ripe oranges are grateful and innoxious, 
and unripe ones give rise to griping pains in the bowels. 

For drink, the dyspeptic should drink simple water, or toast 
and water. Some will be the better for weak table-ale, but malt 
liquor usually is apt to disturb the digestive functions, creating 
flatulence and acidity, when some sherry might be substituted, or 
very weak spirit and water. 

Weak tea or coff'ee may be allowed, but chocolate and cocoa 
should be forbidden, on account chiefly of the oil which they 
contain. 

Condiments should be sparingly used by the dyspeptic, for 
they stimulate ; and, if in excess, they will irritate the stomach. 



74 AMERICi\N HOUSEHOLD BOOK OF MEDICINE. 

Of late a sect has sprung up, called the 

Vegetarians, 

who argue against the use of animal food in any form or quantity, 
and in favor of the exclusive use of vegetable aliment and water 
as the natural food of man. Many instances have been published 
by them of restored and improved health having resulted from 
vegetable food alone, where, too, all other means had failed. 
But the arguments in favor of exclusive vegetable diet are not 
based on sound physiology. As usual, where one-sided views are 
held, the most startling assertions have been made, without any 
proofs being adduced; and we are asked to believe what can not 
be admitted. The vegetarian advocate instances Hindoos, and 
'others, who undergo great labor, while living solely on vegeta- 
bles, and the tendency of such a diet to form a peaceable and 
inoffensive character is also boastingly pointed out, as exemplified 
in the Hindoo; and if the diet were the sole cause in operation, 
it would be a great recommendation ; but it may be justly argued 
that the Irish peasant has been obliged, by poverty, to live for 
years on vegetables, yet they have committed as barbarous acts 
of cruelty and murder as the most carnivorous animals could do. 
These advocates point to the ferocity of the carnivorous beasts 
of prey, and ascribe it to the diet; whereas, the ferocity is an 
endowment from nature, to enable them to get their prey and kill 
it. As to the greater strength, derivable from vegetable food, 
we can not receive unsupported assertions, and must continue to 
believe that the mutton. and beef- fed American will, coeteris paribus, 
be found stronger than he who lives on vegetables solely ; and in 
the case of the Hindoo, we must recollect that he is allowed 
milk, which is a highly nutritious animal product. 

A mixed diet seems pointed out by nature as the one best 
adapted to maintain a healthy tone and vigor, and we would 
earnestly warn many well-meaning individuals not to allow them- 
selves to be captivated by plausible arguments; for if they happen 
to be of weak, delicate habit, they may not, probably will not, 
escape scatheless from the trial. It can not be doubted, that a 
change from an animal to a vegetable diet has been of great 
service to some of our citizens; and how has the benefit arisen? 
The habit of these gentlemen appears to be that of sitting down 
to the dinner-table exhausted with mental or bodily labor. They 



PREVENTION OF DISEASE. 75 

bolt doTHi a copious and often luxurious meal as fast as they 
can, and then they hurry off to business again. Can any one 
wonder at the appearance of indigestion among them? An irri- 
table or sub-inflammatory state of the stomach is induced. This 
state is attended with a sensation of gnawing or craving, which is 
mistaken for the return of hunger, and more food is taken in- 
stead of less. If such persons become vegetarians for awhile, 
and eat nothing but vegetable farinaceous food, the stOTnach is 
soothed, its irritability appeased, and the change of diet has done 
great good. 

But let the pregnant female, who never transgresses either as 
to quantity or quality of her food, and who is of delicate habit, 
indulge this vegetarian crotchet, and, most likely, she will do 
mischief to her own constitution, and either kill her baby, or else* 
see it brought into the world a very small, puny, and sickly thing. 

We will now speak, in a summary way, of drinks, alcoholic and 
others. Beer, or malt liquor, is a refreshing, salubrious drink, 
and seems to enable men to undergo much bodily fatigue,. though 
the teetotaler contends that the water-drinker can do more than 
the beer-drinker. Beer does not contain much nutriment ; but 
its cheering action on the system must not be overlooked. It 
contains less alcohol than wine, but more nutritive matter, and 
some bitter tonic, extractive from the hop. It should not be 
drank by the sedentary and inactive. In convalescence it. is often 
useful ; but when the stomach is delicate, or the bowels relaxed, 
beer should be prohibited. Nor should the bilious or dyspeptic 
patient partake of it. In persons of full habit, and of apoplectic 
tendency, again, it should be avoided ; also, when it causes head- 
ache. 

Ales are richer in alcohol, sugar, and gum, than any other 
kind of malt liquor ; but although they are more nutritive, they 
are not fitted for use, on account of their intoxicating, stupefying 
qualities. On some persons they act as purgatives. The pale 
ale, or Indian pale ale, is superior, because, having been carefully 
fermented, it is dry, and it contains a double proportion of hops. 
Porter is better adapted for table use than strong ale, only it is, 
unfortunately, so strongly adulterated as to be rendered poison- 
ous. Three pounds of cocculus indicus to every ten quarts of 
malt is the proportion of poisonous adulteration which used to 
be usual in the trade. Cocculus indicus gave porter its inebri- 



76 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

ating power ; quassia, its bitter ; grains of paradise and cayenne, 
its pungency; coriander and caraway, its flavor; liquorice, treacle, 
and honey, its color and consistence; while a mixture of green 
vitriol, alum, and common salt, called beer heading, gave a fine 
frothy or cauliflower head to beer. 

Wine, — In this term we will not include the fermented juice 
of fruits generally, as of gooseberries, currants, etc., but we will 
restrict it to those wines which are obtained from the juice of 
the grape solely. 

Every wine has a peculiar odor, called its bouquet or perfume, 
and which depends on the presence of some volatile principle 
generated during the process of vinous fermentation. The wines 
of warm climates possess no smell, says Liebig. Wines grown 
in France have it in a marked degree; but in wines from the 
Rhine, the perfume is most intense. The kinds of grapes which 
on the Rhine ripen late, or hardly ever completely, have -the 
strongest perfume or bouquet, and contain much tartaric acid. 
It is evident that the perfume of wines and their acid have some 
connection, the acid influencing the bouquet. 

Wines vary in the quantity of alcohol they contain. Those 
which contain but little of it, are called light wines, as claret, 
sauterne, hock. Moselle. The more generous wines are Lessa, 
Port, Marsala, Madeira, and Sherry. "The quantity of alcohol 
in them is modified by keeping them in casks or bottles. Ma- 
deira and sherry, kept for a moderate term of years, become 
somewhat stronger, the sugar in them becoming slowly con- 
verted into alcohol, while tartar is deposited. When all the sugar 
has disappeared, the formation of alcohol ceases, and the wine 
diminishes in strength from this period, partly by evaporation 
of the spirit through the cask, and partly by its conversion into 
other substances, as acetic acid." 

Some wines contain much sugar, as Tokay, Tent, Frontignac, 
Lusel, Rivesalte, Constantia, and Malmsey. The process of fer- 
mentation has been arrested in these wines before all the sugar 
was decomposed. In dry wines, as in sherry, all the sugar has 
been decomposed. 

Wines contain acid, more or less. In old and spoiled wines, 
this acid is the acetic acid. In the brisk, frothing, sparkling, or 
efi'ervescent wines, it is carbonic acid; in port it is tannic acid. 
Some contain cream of tartar, also coloring matter. 



PEEVENTION GF DISEASE. 77 

The tartar of wines is bitartrate of potash, or cream of 'tartar, 
and it is deposited from wine along with coloring and extractive 
matters, both in the cask and bottle, forming what has been 
called argol — the crust, the bee's wing — and the deposit aug- 
ments with the formation of alcohol. 

Beer differs from wine in containing less alcohol, but more 
nutritive matter, and, in addition, a bitter tonic extractive de- 
rived from the hop. 

Wine moderately used (a couple of glasses, or three or four 
daily), proves a grateful stimulant; but it is a valuable restora- 
tive when the mind and body has been enfeebled or exhausted. 
It is fitted for those who live a life of activity, and not for the 
indolent and sedentary. Still, the most perfect health is com- 
patible with total abstinence from wine; and it is far better to 
do without wine, except when wanted as a medicine, than it is 
to drink it, however moderately, because a habit is soon en- 
gendered. The abuse of wine brings on many disorders, which 
are too well known to require enumerating here. 

Wine produces different effects on the system from those caused 
by spirits. Wine exerts a tonic influence, spirits do not; wine 
stimulates more slowly, and the stimulus subsides more slowly, 
than in the case of spirits, wherefore wine is the better tonic for 
convalescents. Diseased liver and delirium tremens are caused 
by excess in spirit-drinking; not so, or very rarely so, in wine. 
But wine favors gravel and gout. Wine-drinkers are fat, lusty, 
plethoric; spirit-drinkers are generally thin and emaciated. The 
intoxicating influence of wine is not equal to that of correspond- 
ing mixtures of spirits and water. Old wines are less intoxica- 
ing than new ones, because the alcoholic strength is lessened. 

Sweet wines are improper for the dyspeptic, and also in some 
urinary diseases, as diabetes. Acid wines are improper for the 
gouty and rheumatic. Old wines are preferable to new. Good 
di-y sherry is a good dietetical wine. Five kinds of sherry used 
to be quoted : Very pale, pale, golden, brown, and very brown. 
Pale sherry was once the fashion, and the wine was nearly spoiled ; 
for the wine-growers, to meet the demand, made their wines be- 
fore the grapes were ripe. The gouty, those troubled with uric 
acid (red deposit in their urine), or acidity of stomach, should 
drink sherry. 

Of all the wines produced in the United States east of the 



78 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Eocky Mountains, the Sparkling Catawba is the best. The Still 
Catawba is a good wine, in many cases equal to the sparkling; 
and there is now coming into use the Ives's seedling wine, which 
has justly a very high character, while new kinds of native wines 
are being constantly introduced as the cultivation of the grape 
becomes more extended in the country. There is, however, 
some difficulty in getting these wines in a pure state; still, they 
can be obtained in a less adulterated condition than any of the 
foreign wines. The wines of California are among the best in 
the world; but it is to be feared that wines of that name are 
manufactured east of the great range of mountains. We mean 
those sold in the eastern United States. 

Port Wine. — Old Port is of a duller brown, paler tint than 
new Port, which has a more purplish, redder, deeper, and far 
brighter color; and small silver dishes, with raised bottoms, are 
the tasters employed in the trade to show this color. Port is 
more apt to disorder the head and stomach than sherry, and also 
to constipate the bowels. It is more resorted to when there are 
relaxed bowels; and it is supposed to be more strengthening 
than other wines. 

Madeira is stronger and more acid than sherry. Brandy is 
usually added to it before it is shipped, and its voyage to the 
East Indies improves its quality by the heat and agitation during 
the voyage. This wine is well adapted for old persons and de- 
bihtated constitutions, and it is a very good wine for invalids, 
where its acidity is not likely to disagree. 

Char)ipagne is divided into the red or pink, and the white ; also 
into the still and the sparkling. Of the still kind, the Sillery is 
the best ; of the sparkling, the wine of Ay is preferred ; and the 
demi-mousseux, which only creams on the surface, is often pre- 
' ferred to the full-frothing, the grand-mousseux. The efferves- 
cence depends on an evolution of carbonic acid gas. 

If carbonic acid gas be condensed into ordinary white wine, it 
usually renders the latter turbid, owing to the precipitation of 
the gliadine, (gliadine is usually found combined with gluten, 
and is contained in the wine,) but if we previously precipitate 
the gliadine by adding tannin, the turbidity may be prevented. 

Champagne exhilarates and quickly intoxicates, and it is diu- 
retic. It is fitted for nervous people, and depressed spirits, but it 
is apt to occasion headache. It is useful to allay vomiting ; it is 



PREVENTION OF DISEAgE. 79 

objectionable in goutj subjects. The German wines from the 
Rhine and the Moselle are light, and have a powerful bouquet; 
thev contain tartrate of alumina and potash. The inferior kinds 
are naturally acid; not so the superior. These wines are ex- 
tremely durable. 

The Johannisherger stands at the head of the Rhine wines. 
Its flavor and perfume are very choice, and there is a total want 
of acidity. Steinberger, Rudesheimer, Hockheimer, etc., follow 
in rank. The term Hock (an abbreviation of Hockheimer) is 
applied to the first growths of the Rhine. The inferior Rhine 
wines are called Rhenish wines. 

The Schartzherger is the most esteemed of the Moselle wines. 
The German wines, when of good quality, are light and whole- 
some, but are objectionable on account of their acidulous char- 
acter. They prove diuretic and slightly aperient; and as they 
hold tartar in solution, Liebig asserts that crystals of uric acid 
are never deposited from the urine under their use. 

Claret Wines come from the neighborhood of Bordeaux. La- 
fitte, Latour, Chateaux-Margaux, and Haut-Brion are the dif- 
ferent kinds. They are light and wholesome wines, but they are 
objectionable for those who suiBfer from gout, rheumatism, or in- 
digestion. 

Burgundy is a stimulant, and rather astringent; it is apt to 
occasion headache or indigestion. 

Ardent Spirits. — The value of these is proportionate to the 
alcohol they contain. The spirit called proof-spirit at present, 
by Sike's hydrometer, should have the specific gravity 0.920 at 
60° of Fahrenheit. Any heavier spirit is under-proof; lighter is 
overproof. Formerly the proof of spirits was thus made: The 
spirit was poured upon gunpowder in a dish and inflamed. If, at 
the end of the combustion, the gunpowder took fire, the spii^it 
was said to be above or over-proof, but if the spirit contained 
much water, the powder was rendered so moist that it did not 
take fire; in this case, the spirit was below or under-proof. But 
this mode of proof was open to errors, and proof-spirit is now 
defined to be such, that at the temperature of 51° Fahrenheit 
thirteen volumes of it weigh as much as twelve volumes of water, 
and such a spirit consists of 

By Weight. Specific Gravity. 

Alcohol 49 0.791 

Water 51 1.000 



80 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Brandy. — The Cognac and Armagnac brandies are the best. 
Pale brandy has a brownish yellow tint; the high-colored is ar- 
tificially colored. Ten per cent, under proof is what is usually 
sold. 

It is cordial and stomachic — relieves spasmo^lic pains, wind in 
stomach, checks vomiting ; useful in some cases of indigestion, 
with pain after taking food. Warm brandy and water, and nut- 
meg and burnt brandy, are useful in diarrhea. 

The U. S. "Pharmacopseia" has admitted an excellent res- 
torative mixture in cases of typhus and putrid fevers, etc. It 
consists of brandy and cinnamon water, four ounces of each, the 
yolks of two eggs, half an ounce of white sugar, and two drops 
of oil of cinnamon. Two or three table-spoonfuls in all cases of 
exhaustion from low fevers, floodings, discharges of blood, etc. 

Rum. — General effects similar to those of brandy. But rum 
is considered more heating, more likely to cause sweating; where- 
fore it is often given in slight colds, coughs, and rheumatism. 
It has been found of great value when sailors and others have 
had to suffer privation and exhaustion. This is sold 10 per cent, 
under proof generally. 

Gin. — Not allowed to be sent out stronger than 17 per cent, 
under proof; but is usually sold to the trade at 22 per cent, 
under proof. 

Gin is powerfully diuretic, on account of its oil of Juniper; 
it is, therefore, given in dropsies, and also to promote menstrua- 
tion. 

Whisky is a corn spirit, and agrees with gin in most of its 
properties. The smell of burned turf, called peatreek, has been 
imitated by impregnating bad raw grain whisky with peat-smoke; 
so this is no longer prized as a criterion of good whisky. High- 
land whisky is often 11 per cent, over proof, and the whisky of 
the Lowland distillers is not considered so good as that of the 
Highland, because the former, the Lowland distillers, use porter 
yeast in their distilling. There is a vast deal of very bad whisky 
sold in the United States, much of it being a villainous compound 
instead of pure liquor. A good article of Bourbon or rye whisky 
can occasionally be obtained, but great care should be exercised 
in selecting it for medicinal purposes. 

Arrack, or Rack, has been called rice spirit, being distilled from 
fermented infusions of rice, or cocoa-nut toddy. Pine- apples 



PREVENTION OF DISEASE. 81 

steeped in it, give it an exquisite flavor, and, by age, it becomes 
a delicious liquor, unrivaled for making nectarial punch. It pos- 
sesses stimulating and narcotic properties beyond other spirits. 
A mock arrack is made by dissolving twenty grains of benzoic 
acid in two pints of rum. 

Of the various liquors, the Ratafias, the Cremes, the Kirsch- 
wassers. Maraschino di Zara (from a peculiar cherry, the maras- 
quin), the Curacoa may be mentioned. The various British liquors 
need not be detailed; their specific gravity runs from 64 to 80 
under proof. 

We will now shortly advert to the question whether alcoholic 
drinks are permissible, or likely to be beneficial. 

Alcohol has been classed among the elements of respiration ; 
for, when di'ank, it is absorbed, gets into the system, and is con- 
verted into the carbonic acid and water appearing in the expired 
breath. By its oxidation in the lungs, it must evolve caloric, and 
when used in moderation, it serves to support the temperature of 
the body ; and the teetotal societies have never discussed alcohol 
under this point of view. But, though alcohol evolves heat ia 
burning, it is an obnoxious fuel; its volatility, and the facility 
with which it permeates membranes and tissues, enable it to be 
rapidly absorbed, and when it gets into the blood it exerts on 
the brain and liver a most injurious operation before it is burnt 
in the lungs. By its combustion, heat is evolved; yet, under 
certain circumstances, there are other better, safer, and less in- 
jurious combustibles to be burned in Jhe vital lamp. Alcohol 
has been detected in both brain and liver of those who have died 
under its influence, and it doubtless exerts some topical action on 
these organs. The immediate prejudicial influence spirits exert 
on the coats of the stomach, has been rendered visible in Dr. 
Beaumont's case of the wounded Canadian voyager, the coats of 
"whose stomach, after drinking, Showed diseased color, patches of 
ulcers, and an inflammatory redness all over it ; yet the man him- 
self had no warning symptoms of such a state, which adds to the 
danger of such a case. 

Where general health is perfect without alcoholic drinks, they 
ought never to be taken, for they are sure to cause excitement, 
and excitement is always followed by a corresponding depression. 
Sir J. Richardson, the Arctic traveler, says spirits give a tem- 
porary stimulus, but they diminish the power of resisting cold. 
6 



B2 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

He says a Canadian, with seven or eight pounds of beef or venison 
in his- stomach, will resist the greatest degree of natural cold in 
the open air, and thinly clad, too, if there be no strong wind, 
"We found, on our northern journey, that tea was much more re- 
freshing than wine or spirits, which we soon ceased to care for, 
while the craving for tea increased/' A cup of warm coffee, or 
a basin of hot soup, may answer the purpose of alcohol, and be 
more permanent in their effects. Many facts are now on record 
to show the advantage of discontinuing spirituous drinks, as well 
as of living without them under most of the circumstances of 
ordinary life. Still, there are circumstances when wine or spirits 
may be advantageously taken, which may then be regarded as 
medicines, adapted for a temporary state ; as, for instance, when 
we have no means at hand for warming coffee, etc., and when chilli- 
ness is upon us, which, if unchecked, may lead on to the reaction 
of inflammation. Again, where the constitution or health is so 
deficient, or the exertions required by the mode of life are so 
great, that the system can not be sustained in proper vigor 
without some additional stimulus. But when fermented liquors 
quicken the circulation, excite the mind, or disorder the digestive 
functions, they are evidently to be avoided, for they will be sure 
to do harm. 

Many assert that excessive use of spirituous liquors predis- 
poses and has given rise to spontaneous combustion in the human 
body ; that the textures in the bodies of habitual drunkards have 
become so universally imbued with inflammatory gases, that under 
certain circumstances the galvano-electric fluid in the body sets 
fire to the body, which burns away into an oily, greasy, tarry, 
fetid, sooty ash — the sole remnant of what was once a living, 
moving being, the abode of mind, and the inclosure of a soul, 
which should be immortal. However much one might desire to 
warn the drunkard and deter him from his debasing habit of 
drinking, by pointing out to him the probability of a similar fate, 
and however poetical and awfully deterring such a just retribu- 
tion for the suicidal practice of habitual intoxication may appear, 
still we can not do so with truth, for the cases of spontaneous 
combustion are not proved. 



PREVENTION OF DISEASE. 83 



Spoxtaxeous Combustion 



of the Imman body was supposed to have occurred in the year 
1725, when the first recorded case took place. A miller's wife, 
at Rheims, was found burned in her kitchen ; and all the remains 
left consisted of some parts of the head, the legs, and the verte- 
brae. The miller had a pretty servant-girl, and suspicion was 
aroused — a criminal inquiry instituted ; but the man was aquitted 
on the ground of spontaneous combustion. Now, in those days, 
the true theory of combustion was not known, and the conditions 
necessary for continued combustion had not then been dis- 
covered. 

Since that time, from forty-five to forty-eight cases have oc- 
curred, of which the great majority agree in the following points : 
1. They took place in winter. 2. The victims were brandy-drink- 
ers, in a state of intoxication. 3. They happened where the 
rooms are heated by fires in open fire-places, and by pans of 
glowing charcoal, in England, France, and Italy. In Germany 
and Russia, where rooms are heated by means of closed stoves, 
cases of death, ascribed to spontaneous combustion, are exceed- 
ingly rare. 4. It is admitted that no one has ever been present 
during the combustion. 5. None of the physicians who collected 
the cases, and attempted to explain them, has ever observed the 
process, or ascertained what preceded the combustion. 6. It has 
never been ascertained, invariably, how much of combustible mat- 
ter was on the spot. And, lastly, it is unknown how much time 
had elapsed from the commencement of the combustion to the 
time when the consumed body was found. 

Flesh is not combustible till dried ; and then it is not combus- 
tible by itself, like wood. Living flesh can not burn ; nor does 
steeping it in fat or spirits render it combustible ; and all nitro- 
genous compounds are comparatively incombustible. 

Some advocates have supposed the generation of phosphureted 
hydrogen in the human body. Such a gas will take fire instantly 
on coming into mere contact with the air; but the presence of 
such a gas in the human body has never been observed, either in 
health or disease, nor even in the putrefaction of dead bodies ; 
and, moreover, the human body contains no phosphorus in such 
a state as to yield, by any process during life or after death, 
phosphureted hydrogen gas. Besides, such a gas as this is 



84 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

poisonous as arsenic, and could not be present in the blood of 
any living animal. 

The circulation of the blood in the living body renders its spon- 
taneous combustion absolutely impossible. Dry animal substance, 
such as flesh, is not in itself difficult of combustion. Indeed, up 
to the charring, point, it is easily combustible, as may be seen in 
a piece of horn, or in shavings of horn ; and flesh dried behaves 
exactly as horn does. But all these tissues and textures become 
difficult of combustion in consequence of the water they contain 
in a fresh state, amounting in the flesh to 75 parts, and in the 
blood to 80 per cent.; and the water is contained as in a sponge 
with very fine pores. It can not be heated beyond 212°. of Fah- 
renheit, the boiling point, whereas even fat requires a tempera- 
ture of 800° of Fahrenheit before it will burn. The accounts 
transmitted to us have been at first from ignorant persons ; and 
in their credulity and eagerness to substantiate the cases, they 
usually state that the body entirely disappears down to a greasy 
stain on the floor, and some remains of bones. This is impossi- 
ble. The smallest bit of bone, in the fire, becomes white, and 
loses somewhat of its bulk ; but of its weight, there remains from 
60 to 64 per cent, of earthy matter, commonly retaining the 
form of the original bone« 

Those who are interested in this question of spontaneous com- 
bustion had better read the familiar Letters on Chemistry, by 
Baron Liebig, from whose pages the above written statements are 
taken ; and they may rest assured that, in all such cases, if the 
true evidence can be got at, it will probably be found that a man 
goes to bed drunk, and, in looking for any thing under the bed, 
may leave his candle burning; or he may so leave it that it sets 
fire to the curtains or coverings of his bed — the drunkard becomes 
asphyxiated, and soon lies a charred corpse. But if we wander 
into gaseous and electrical theories to account for what is simple 
enough, the wildest and most startling assertions must be swal- 
lowed, without an atom of proof. 

We may regret the loss of a terribly warning example to deter 
from drunkenness; but quite enough remains to deter any one 
from drinking, in the shape of the inward burning which takes 
place from disease of the liver and stomach, and which deprives 
the unfortunate victim of drunkenness of all the enjoyments of 
life. 



PREVENTION OF DISEASE. 85 



Cookery for the Sick and Convalescent. 

As to boiling, roasting, etc., something has already been said; 
but we may here add, that in boiling much depends on the 
manner of conducting the process. If the boiling be too quick, 
the digestibility of the meat is diminished, the albuminous mat- 
ter is coagulated, the flesh on the outside rendered hard, and 4:he 
interior not sufficiently done. The water should scarcely be 
brought to the boiling temperature, but kept simmering. Every 
kind of meat for invalids, except poultry, should be put on the 
fire in cola water, and very slowly boiled. 

Beef and mutton boiled in hard water is always more tender 
and juicy than when soft water is employed — the solvent pro- 
perties of the water increasing, probably, with its density. Fish, 
however, is rendered firm in the ratio of the hardness of the 
water in which it is boiled. Fish boiled in sea water, or in water 
containing much salt, will be found firmer and finer flavored than 
if boiled in soft water, or water without any salt added. 

Vegetables require rain or soft water, adding some salt; they 
should always be well, indeed thoroughly, boiled in two waters. 

Stewing is a good form of cookery for the convalescent and 
the invalid. 

Baking is inadmissible, except certain puddings. 

Boasted meat is more nutritive than boiled meat, if properly 
and exactly done; but it is less easily digested. Mutton loses 
one-fifth, and beef one-fourth, of its weight by boiling ; but both 
lose only one-sixth in roasting. Underdone roasted meat is not 
well adapted for weak stomachs, as we have before said; this is 
an error generally entertained. The digestibility of the meat is 
in the ratio of the softness of the fiber, and that property is in- 
creased by slow boiling. 

Frying and broiling should be banished from sick-room cookery. 

Cookery for the Sick-room. 

This comprises farinaceous preparations, animal teas, broths, 
milk, and drinks. 

Farinaceous preparations are modifications of starch. They 
are not capable of conveying much nourishment into the habit; 
but, being mild and devoid of stimulant properties, they are well 
calculated for the sick. 



86 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Arrowroot Mucilage. — Rub "a table-spoonful of the arrowroot 
powder, with a little cold water in a basin, by means of the back 
of a spoon, till it is well mixed; then pour boiling water over it 
till a soft, tenacious, gelatinous mucilage is formed; lastly, boil 
for five minutes. This quantity of the powder will make a pint. 
Sugar may be added, or lemon-juice; but cinnamon powder, or 
any astringent, precipitates the starch, and destroys the smooth- 
ness of the mucilage. If wine is added, do not add Port wine. 

Tons les Mois. — A starch prepared from the tubers of a species 
of canna, in Peru. It is the same as arrowroot, and prepared in 
the same way. They both convey but a small quantity of nu- 
triment into the system, and hence they are useful to satisfy 
prejudices, in affording the semblance of providing nourishment, 
when it is not wanted, or might prove injurious. 

31ucilage of Sago.—^Ssigo is the pith of palms and cycadeae in 
tropical climates, as at Malacca. Pearl sago, the best, contains 
starch and some salt. An ounce, or a table-spoonful of it, should 
be placed in a pint of water in a pan, placed on the hob, or on 
a hot plate, for two hours; then boil for fifteen minutes, stirring 
well all the time. It may be sweetened with sugar, or flavored 
with lemon-juice ; or milk may be added. It affords very little 
noilrishment, and may be given to invalids laboring under acute 
diseases. 

Tapioca Mucilage. — Tapioca is the pith of the roots of jatro- 
pha manihot, in Brazil, and is combined with a poisonous prin- 
ciple in the first state ; yet is easily freed from it by washing in 
cold water, after the roots are barked and crushed. The fecula 
is then dried and granulated. It resembles sago; but it is less 
colored, and its grains are larger. The mucilage is prepared and 
flavored in the same way as sago; only as it is more soluble than 
sago, it requires only half the time for maceration and boiling. 

Infants, about the time of weaning, relish this tapioca more 
than any thing, and it is less apt to become sour during diges- 
tion than even arrowroot or other farinaceous food. 

Mucilage of Salep. — Salep is prepared from the bulb of the 
orchis mascula. It comes from the Levant and India, and con- 
sists of a gum termed bassorin and fecula. It is more nutritive 
than either arrowroot or sago, and is better adapted for the con- 
valescent than the sick. The mucilage is prepared by dissolving 
the powdered salep in hot water, with assiduous stirring, and 



PKEVENTION OF -DISEASE. 87" 

adding to the solution sugar and milk. Salop and flour is said 
to make excellent bread. 

Grit Gruel. — Wash well three ounces of grits (grits are oats 
freed from their cuticle or testa, and coarsely broken) in cold 
water; pour off the fluid; put them into four pints of fresh 
water; boil slowly till reduced to one-half; strain the whole 
through a sieve, to separate the mucilage from the undissolved 
part of the grits. 

Oatmeal Gruel. — Rub two ounces of oatmeal, free from musti- 
ness, in a basin, in a small portion of a pint and a half of soft 
water; pour off the fluid after the grosser particles have sub- 
sided, but while the milkiness still continues, and repeat this 
operation till no more milkiness is communicated to the waters. 
Put the washings into a pan, stirring well, to suspend any fecula 
which may have subsided, and boil till a soft, thick mucilage is 
formed. 

The gruel of grit and of oatmeal consist not only of the starch 
of the oat, but contain also a small proportion of gluten, where- 
fore they are more nutritious than any of the feculaceous muci- 
lages. They may be sweetened or acidulated, or mixed with 
milk, according to circumstances. Some add butter and honey, 
which are inadmissible in inflammatory diseases. Gruels are 
convenient vehicles for clysters, as they are not so susceptible 
of precipitation by astringent vegetables or decoctions as the 
purer starches are. 

Gruel is apt to ferment if kept longer than twenty-four hours. 

Mucilage of Iceland Moss, or Jelly. — This contains a bitter, 
and if we wish to remove the bitter, the dried lichen must be 
pounded, and soaked for twenty-four hours in tepid water, con- 
taining a small quantity of carbonate of soda, and forcibly press- 
ing through a coarse cloth; if bitter still remain, repeat the 
process. 

To make the jelly, put an ounce of the dried moss to a quart 
of water, slowly boiled down to one-half; strain through a sieve ; 
sweeten, acidulate, or add milk, as you may desire. The bitter 
should be retained, if we wish to obtain the utmost possible good 
from the moss. 

Carrageen, or Irish Moss. — This is a fucus. Boil an ounce in 
a pint and a half of water ; add sugar, acid, or milk, and the jelly 
is excellent to support the invalid's strength. 



88 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Mucilage of Rice. — Wash an ounce of good Carolina rice, and 
macerate it in a quart of tepid soft water for three hours, in a 
pan, placed on a hob; then boil the whole slowly for an hour, 
and strain through a sieve. 

Sugar, acid, or milk may be added as usual; and this forms 
an excellent diet in irritable conditions of the bowels and in diar- 
rhea, but it is quite a mistake to suppose that it possesses any 
astringent property. An hundred millions of the inhabitants of 
this earth live upon rice; but they add milk to their diet. Rice 
is not very nutritious. Its soluble part is chiefly starch, eighty- 
five in one hundred parts. There are 3J per cent, of an ani- 
malized principle and some phosphate of lime. The animalized 
matter furnishes whatever nutriment there may be in rice; but 
in the mucilage this animalized principle is not taken up. 

Ground Rice Milk. — Rub a table-spoonful of ground rice smooth 
with a pint and a half of milk ; add half an ounce of candied lemon- 
peel, cut into small pieces ; boil for half an hour, and strain while 
the milk is hot. 

This is an excellent nutritious beverage for the sick, when 
strict abstinence is not required. It is well adapted for early 
convalescence. 

Simple Bread Panada. — Put any quantity of grated stale bread 
into water enough to form a moderately thick pulp ; cover it up, 
and leave it to soak for an hour ; then beat it up with two table- 
spoonfuls of milk, and a small portion of refined sugar; boil the 
whole for ten minutes, stirring all the time. 

This is useful whenever strict abstinence is not enjoined. 

Animal Preparations. 

Hartshorn Jelly. — Cut six ounces of hartshorn shavings into 
small pieces ; boil them in four pints of water down to two ; 
strain, and add to the liquor, while hot, two table-spoonfuls of 
lemon-juice, six ounces of white sugar, and two glasses of sherry. 
This is good nutriment when wine is not forbidden. Or, instead 
of the acid and wine, milk in equal quantity may be added, and 
may be given as a substitute for breast milk to infants brought 
up by hand. 

Beef Tea. — Cut half a pound of lean rump-steak into thin 
slices ; sprinkle a little salt over them, spread out in a hollow 
dish, and pour a pint of boiling water over them ; cover the dish 



PKEVENTION OF DISEASE. 89 

and place it for an hour near the fire ; then put the whole into a 
pan, cover it, and boil for a quarter of an hour; then strain 
through a sieve. The resulting beef tea is very strong, and may 
be reduced by adding boiling water. 

Chicken Tea. — Free a small chicken from fat and skin ; divide 
it in two halves, longitudinally ; remove lungs, liver, and all from 
backbone and ribs ; then cut it, bones and muscles, into as^thin 
slices as possible; put all into a pan with some salt, and pour a 
quart of boiling water over them ; simmer slowly for two hours ; 
put the pan on a hob for an hour, and strain. 

Farinaceous additions may be made. 

Veal Tea. — Made as beef tea is. A pound of fillet of veal, 
freed from fat, and sliced ; a pint and a half of boiling water ; 
and boil for half an hour. The fleshy part of the knuckle of 
veal will do instead of the fillet. Strain ; the decoction becomes 
a jelly ; and in small cups will keep for several days, and may be 
used by adding an equal quantity of boiling water to a cupful of 
it at any time. 

Mutton Tea. — A pound of mutton, freed from fat, and in slices, 
to a pint and a half of boiling water ; let it stand to macerate ; 
then boil for half an hour, when it may be strained. 

An ounce of good pearl barley, washed and macerated in boil- 
ing water for an hour, may be boiled with the mutton tea, and 
the undissolved barley separated by straining. 

Tu7ile Soup. — Plain turtle soup made from the green turtle, 
without wine or spices, is sold in pots, and wants only the addi- 
tion of water to make a soup very nourishing and easy of 
digestion. It should be given only in small quantities, at mod- 
erate intervals. Wine or brandy may be added, if demanded by 
circumstances. 

Toast Water. — Toast to a brown, not to a black cinder color, 
half a slice of a stale quartern loaf; put it into a jug, and pour 
a quart of water over it, which has been boiled and cooled ; decant 
after two hours. Orange and lemon-peel put in with the bread 
is a grateful addition. 

A29ple Tea, or Water. — Slice two large apples, not over ripe, 
and pour a pint of boiling water over them ; after an hour decant 
the hquid and add sugar. 

Lemon-peel Tea, or Water. — Pare the rind of one lemon, which 
has been previously rubbed with half an ounce of refined sugar ; 



90 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

put both peelings and sugar into a jug, and pour over them a 
quart of boiling water. When cold, pour off the liquid, and add 
one table-spoonful of lemon-juice ; and a glass of sherry added, 
or instead of the lemon-juice. 

Orgeat. — Two ounces of sweet almonds, and four bitter almonds 
blanched, are to be beaten in a mortar, with a little orange-flower 
water, into a paste; rub this with a pint of milk, diluted with a 
pint of water, until an emulsion is formed; strain and sweeten 
with sugar or capillaire. 

Raspberry Vinegar Water. — This is diluted raspberry vinegar. 

Lemonade. — Add the juice of two lemons to a quart of boiling. 
"Water, having the rind of one of the lemons in it, in a covered 
jar; sweeten moderately with sugar or capillaire. 

Barley Water — Simple. — Two ounces and a half of pearl bar- 
ley to four and a half pints of soft water ; wash the barley with 
cold water, then pour upon it half a pint of water, and boil for 
fifteen minutes; throw this water away; then, having heated the 
remaining four pints, pour them upon the barley, and boil down 
to two pints, and strain. 

Compound Barley Water. — To two pints of simple barley water, 
add two and a half ounces of figs, sliced ; five drachms of liquor- 
ice-root, sliced and bruised ; two and a half ounces of raisins, and 
a pint of soft water ; boil down to two pints, and strain. 

These are good demulcents when blisters are troublesome, and 
in urinary disorders. An ounce of gum added and dissolved is a 
good addition, when there is pain or difiiculty in making water. 

Simple barley water, with an equal quantity of milk and some 
sugar, is a good substitute for the breast milk. 

Almond Emulsion. — Beat one ounce and a quarter of blanched 
sweet almonds and five drachms of sugar into a pulp, in a por- 
celain mortar, and add water gradually until a quart is added; 
then strain through linen. A good demulcent in fevers. 

Marsh Mallow Tea. — Four ounces of dried roots of the marsh 
mallow, two ounces raisins freed from the seeds, and five pints 
of boiling water. Boil slowly down to three pints ; let the sedi- 
ment subside ; pour off the clear liquor. Useful in gravel diseases. 

Linseed Tea. — One ounce of linseed, not bruised ; two drachms 
of liquorice-root, bruised ; one pint of boiling soft water ; place 
the jug containing these on the hob, covered, for four hours; 
Btrain through linen or calico. 



PREVENTION OF DISEASE. 91 

The mucilage resides in the husks, and the fixed oil in the 
kernel of the linseed, wherefore the seeds ought not to be 
bruised. 

When linseed is boiled, the fixed oil is extracted, and renders 
the decoction nauseous and unpleasant. 

Useful in coughs ; gravel disorders. It must be made daily, 
as it soon gets ropy and spoils. 

Rennet Whey, — Infuse a moderate-sized piece of rennet in a 
sufficient quantity of boiling water to extract the soluble matter ; 
separate the fluid, stir a table-spoonful of it into three pints of 
milk, cover up with a clean cloth, and place it before the fire till 
it forms a uniform curd. Divide this curd with a spoon, and 
press it gently so as to separate the whey. Nutritive and diluent. 
Whey constitutes 92 parts in every 100 of milk. 

Rennet is the inner membrane of the cairs stomach ; it coagu- 
lates milk by a peculiar substance, called chymosine. The quan- 
tity of liquid rennet necessary to curdle 1,000 grains of milk is 
only eight drops ; but it requires a heat of 68° Fahrenheit, and 
its action is aided by the acidity of the rennet. 

Vinegar and Tamarind Wheys. — A small wine-glassful of vine- 
gar, sweetened with a dessert-spoonful of muscovado sugar, or else 
two table-spoonfuls of tamarinds, stirred in a pint of boiling 
milk ; boil for fifteen minutes, and strain. 

White Wine Whey. — Add to two-thirds of a pint of milk 
enough water to make up a pint. Take two glasses of sherry, 
or any other good white wine, and a dessert- spoonful of musco- 
vado sugar ; place the milk and the water in a deep pan upon the 
fire, and watching the moment when it boils, which is known by 
a scum rising to the edge of the pan, pour into it the wine and 
sugar, stirring assiduously while it continues to boil, for twelve 
or fifteen minutes ; strain the whey through a sieve. 

In low fevers, when wine is wanted in small quantities, this is 
a good mode of administering it; it may be drank cold or tepid 
in a wine-glassful at a time. 

Mustard Whey. — Boil together half an ounce of bruised mustard 
seeds and one pint of milk ; boil them together till the milk is 
curdled, then strain. Give a tea-cupful at a time in dropsy ; it 
stimulates the kidneys and augments the urinary organs. 

Artificial Goafs Milk. — Cut an ounce of fresh suet into small 
pieces; tie them in a muslin bag, large enough to hold the pieces 



92 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

"without compression ; boil this in a quart of cow's milk, sweetened 
with, a quarter of an ounce of sugar-candy. This is useful in 
scrofula, in atrophy, in consumption, and for infants brought up 
by hand. 

Artificial Asses^ Milk. — Dissolve half an ounce of gelatine, by 
heat, in a quart of barley water; add one ounce of refined sugar; 
pour into the mixture a pint of new milk, and beat up with a 
whisk. It should be drank warm, and exercise taken after it. 

Milk and Soda Water. — Heat, nearly to boiling, a tea-cupful of 
milk ; dissolve in it a tea-spoonful of refined sugar, put it into a 
large tumbler, and pour over it two-thirds of a bottle of soda water. 

Useful to give milk when there is acid in the stomach. 

Buttermilk. — Put a quart of new milk into a half-gallon bottle ; 
cork the bottle, and cover it with a towel in such a manner that, 
by drawing alternately each end of the towel, the bottle can be 
rolled upon a table. Open the bottle while rolling, occasionally, 
to admit air; when the butter has separated, pour ofi* the milk. 
A nice cooling beverage in fever, or in states of excitement. 

Sago Posset. — Boil two ounces of sago in a quart of water, till 
a mucilage is formed ; then rub half an ounce of loaf-sugar on 
the rind of a lemon, and put it, with a tea-spoonful of tincture 
of ginger, into half a pint of sherry; add this to the mucilage, 
and boil for five minutes. An excellent cordial in debility, after 
acute diseases. Dose: a large wine-glassful every four or five 
hours. 

Cookery for the Convalescent. 

Boiled Flour and Milk. — Knead wheaten flour into^ a ball, with 
water, and tie firmly in a linen cloth; put it into a pan, with 
water, and boil for twelve hours. Place it before the fire to dry, 
and, on removing the cloth, separate a thick skin or rind which 
has formed, and again dry the ball. A table-spoonful or more 
of this, grated, and boiled with a pint of milk, forms an excellent 
article of diet in convalescence from dysentery, diarrhea, and 
emaciations. 

Arrowroot Pudding. — Rub a table-spoonful of arrowroot powder 
with a little cold water, in the same way as in making the muci- 
lage ; and add to it, while constantly stirring, a pint of boiling 
milk with this mucilage; mix the contents of one egg, and two 
or three tea-spoonfuls of powdered, refined sugar, previously 
beaten up together. Bake or boil this pudding in a basin. 



PREVENTION GF DISEASE. 93 

A table-spoonful of Scotch orange marmalade may be added 
to this pudding, if desired. 

Arrowroot Blanc-mange. — Make arrowroot mucilage with three 
times the quantity of the arrowroot powder ; add milk in a mod- 
erate proportion ; boil down to a sufficient thickness ; pour it into 
a shape, and set; then turn it out. This may be eaten with 
currant jelly or with wine, or lemon-juice and sugar. It is some- 
times eaten with cream, but cream is improper for convalescents. 

llilk, or Beef Tea Arrowroot Mucilage. — Make, as in simple 
arrowroot mucilage, except that beef tea or milk boiling is used 
instead of water; and the mucilage must be boiled twenty minu- 
tes instead of five. 

Flummery, or Sowans. — Rub a quart or any quantity of grits, 
or of oatmeal, with two quarts of hot water for some time ; then 
leave the mixture for several days to get sour ; then add another 
quart of hot water, and strain through a hair sieve. Leave the 
strained fluid to deposit a white sediment (the starch) ; pour off 
the water, and wash the sediment with cold water. The washed 
sediment may be boiled with fresh water, stirring all the time it 
is boiling, until a mucilage or jelly is formed; or it may be dried, 
and afterward prepared as arrowroot mucilage is. 

Flummery is light, very digestible, and moderately nutritious; 
and it may be eaten with milk or wine, or lemon-juice and 
sugar. 

Oatmeal Porridge. — Sprinkle into a pint of water, kept boiling, 
small quantities of oatmeal, at short intervals, stirring all the 
time, until the mixture is thick enough; boil for another half 
hour. Eaten with milk, this is nutritious ; but it does not suit 
the dyspeptic, as it is apt to prove acescent. 

Bice and Apples, or Snow-halls. — Boil the rice in hot water 
rapidly; strain off the water through a colander; expose the rice 
for ten to fifteen minutes to the fire; and, having stewed the 
apples separately, mix the two with some sugar. This is more 
digestible than when a paste is formed. No butter should be 
added, and not much sugar. 

Boiled Bread Pudding. — Grate half a pound of stale bread, 
pour a pint of hot milk over it, and leave it to soak for an hour 
in a covered basin; then beat up, with the yolks of two eggs; 
put the whole into a basin, tie over, and boil for half an hour. 
Salt or sugar, or a glass of sherry, may be taken with it. 



94 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Simple Rice Pudding. — Simmer two table-spoonfuls of Caro- 
lina rice in a pint and a half of milk, till the rice is soft; add 
the contents of two eggs, with half an ounce of sugar. Bake 
for three-quarters of an hour in a slow oven. Two glasses of 
sherry are sometimes added. 

Macaroni or Vermicelli Pudding. — Simmer two ounces of mac- 
aroni or of vermicelli, in a pint of milk and two ounces of cin- 
namon-water, till the macaroni is tender; then beat up the yolks 
of three eggs, the white of one, an ounce of sugar, one drop of 
the oil of bitter almonds, and a glass of sherry, in half a pint 
of milk. Add the mixture tcT the macaroni or vermicelli, and 
bake in a slow oven. 

Batter Pudding. — Beat the yolks of two eggs with half an 
ounce of sugar, and mix them with a table-spoonful of wheaten 
flour and a pint of milk ; put the pudding into a basin, tied over, 
in boiling water. 

Tapioca Pudding. — Beat the yolks of two eggs and half an 
ounce of sugar together, and stir the mixture into a pint of 
tapioca mucilage made with milk. Bake in a slow oven. 

Sago, arrowroot, or millet-seed mucilage may, in like manner, 
be made into puddings. 

Mashed Carrots and Turnips. — Boil the carrots and turnips, 
peeled, successively in three waters; press the water strongly 
out of them, through a clean, coarse cloth; mash them together 
with enough new milk to form a pulp, and season with salt; 
place them before the fire till the surface seems dry. 

This is an admirable dish for convalescents, and one they do 
not readily tire of when restricted to farinaceous vegetable diet. 

Plain Boiled Vegetables. — All the cabbage tribe, turnips, car- 
rots, and onions should be thoroughly boiled in two waters. If 
salt be added, and the boihng be brisk, in an uncovered vessel, 
the vegetables will retain their green color. 

Animal Preparations. 

Rice^ or Vermicelli,, or Macaroni Soup. — Make a quart of beef 
tea, as before ordered, and boil down one-third; then add an 
ounce of vermicelH, or two ounces of macaroni, which have been 
previously well boiled in water, and boil down the whole to one 
pint; salt to taste, and add five grains of cayenne pepper to 
each pint. When rice is used instead of vermicelli, it should be 



PREVENTION OE DISEASE. 95 

put into boiling water, and boiled rapidly in a close vessel; then 
thi^wn into a colander and dried before the fire; it should not 
be boiled with the soup, but added after the concentration of the 
soup, in quantity to taste. 

Chicken Broth. — Boil down chicken tea one-half; add a little 
parsley or celery, and the yolk of an Qgg, previously beaten up, 
in two ounces of soft water; and rice, vermicelli, or macaroni 
may be added, and three or four grains of cayenne pepper. " 

Chicken Panada. — Take the white meat of the breast and 
wings of a boiled or roasted chicken, free it from skin, and cut 
into small morsels ; pound these in a mortar, with an equal quan- 
tity of stale bread and some salt, adding, by little and little, 
either the water in which the chicken has been boiled or some 
beef-tea, until the whole forms a thin fluid paste; lastly, put it 
into a pan and boil for ten minutes, stirring all the time. A 
similar panada may be made from the underside of a cold sirloin 
of roasted beef, or from a leg of cold roasted mutton. Either 
should be freed from skin or fat; and the gravy, kept until the 
fat is thrown in a cake and separated, may be added to it. 

This panada is very nutritive for delicate children and con- 
valescents. 

Rice Gravy. — Take the gravy from a leg of roasted mutton or 
a sirloin of beef; leave it at rest till the fat forms a cake on 
the surface ; remove this, and stir into a tea-cupful of it as much 
well-boiled rice as will serve for a meal. 

Gloucester Jelly. — Take of rice, sago, pearl barley, and gela- 
tine, of each one ounce ; simmer the whole in three pints of 
water till they are reduced to two, and strain when cold. A 
strong jelly is formed, which may be dissolved in warm milk or 
in beef tea, or in hot water, and flavored with wine and sugar. 

Sago Milk. — Soak an ounce of sago in a pint of cold water 
for an hour; pour off this water; add a pint and a half of good 
milk, and boil slowly until the sago is well incorporated with the 
milk. 

Mutton Broth with Vegetables. — Put a pound of mutton-chops, 
freed from fat, into a pan with three pints of water; boil them 
slowly, or simmer for two hours ; peel and cut three moderate- 
sized carrots, and three turnips into dice, boil them for half an 
hour in a quart of water; then throw upon the colander to drain; 
and having boiled two onions, sliced, in a pint of water, and also 



96 AMERICAN HOUSEHOLD BOOK OF MEDICIRE. 

poured off the water, add the turnips, carrots, and onions to the 
mutton liquor; after removing the mutton-chops, season with 
salt and a little celery-seed; simmer slowly for four hours; put 
in the chops again, and continue the simmering for another hour; 
the chops may be served up with the broth. This is a palatable 
and nutritive dish for convalescents. Owing to the slow sim- 
mering, the mutton is rendered soluble, and of easy digestion. 

Tripe, — This is very readily digested when properly cooked. 
After partially boiling it in the usual manner, and, also, after 
boiling some onions in two waters, both should be slowly boiled 
together, until the tripe is soft and tender; salt and cayenne 
pepper may be added. 

Sweet-hread. — To be slowly boiled ; eaten with salt and cayenne 
pepper. Well adapted for the convalescent. 

Fowl with Mice. — Free a young fowl from fat and skin, and 
simmer it in good beef tea till it is very tender ; season with salt 
only; and having boiled some rice, as if for curry, add it to the 
liquor before the fowl is dished. 

Aromatic Barley Wine. — Boil a quart of barley-water down 
one-third; add to it, while still hot, a pint of sherry, a drachm 
of tincture of cinnamon, and an ounce of refined sugar. A wine- 
glassful two or three times a day. 

Blulled Wine. — Infuse a quarter of an ounce of bruised cin- 
namon, half a nutmeg grated, ten bruised cloves in half a pint 
of boiling water for an hour; strain, and add half an ounce of 
lump sugar, and pour the whole into a pint of hot port or sherry. 

This is a useful cordial in typhus and low fevers ; and in the 
debility, of convalescence from fevers. 



CHAPTER ir. 

CLIMATOLOGY OF THE UNITED STATES. 

In this chapter we purpose treating of the climate of the United 
States in a general manner, so that the reader may have a more 
correct idea of those parts of the country in which it might be 
best for him to locate, to travel, or to make longer or shorter 
visits, owing to the condition of his health or the season of the 
year, etc. This is more eminently proper, too, because the inva- 
lid of the United States is constantly urged to visit Europe for 
relief from suffering, while there is but little to convince him 
that travel or location in his native land would be of service to 
him, when really no other country has such a variety of climate 
adapted to the recovery of health. 

We shall consider the range of the thermometer, the direction 
and influence of the winds, and the amount of precipitation of 
water in rain and snow, and the causes which produce malaria 
and other diseases, through the influence of swamps, lagoons, 
maf-sh-lands, alluviums, and the peculiar diseases resulting from 
surfaces not infected by malarious causes. We shall, therefore, 
give a general idea of the variability of the climate of the United 
States, founded on facts, ascertained by the accurate observations 
of scientific men, who have, either by their own exertions or the 
order of the Government, turned their attention to the climatology 
of this vast country. Of these we mention, with pleasure, the 
names of Dr. D. Drake and Mr. Blodget. 

The range of the thermometer in the United States is, in the 
general, great when compared with that of Western Europe, with 
the exception of the Pacific coast, where it is less than any place, 
at least, out of the tropics. In all the States east of the Rocky 
Mountains, however, we find the variations great. In the State 
of Maine the mercury often falls below zero many degrees in 
7 (97) 



98 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

winter, and in summer rises to over 80°. These variations are 
common all over the Eastern States ; indeed, in most of the 
country east of the Rocky Mountains. But as we approach 
these mountains, the rise and fall of the mercury becomes 
greater, and continues so on the vast interior plains west of 
those mountains until we reach the coast range west of the Sierra 
Nevada. 

If we take a belt of country across North America, a degree 
or two on each side of the fortieth parallel, we shall find that 
the mercury occasionally reaches 95° in the summer, in the shade, 
and in the winter falls, once in awhile., a few degrees below zero, 
or on rare occasions it may be down to 20° below that point. 
These inequalities are found as low dow^n as Florida; but the mer- 
cury in this State seldom gets so low as zero, but still too low 
for the orange to be always cultivated with safety ; yet^ some- 
times many years supervene without danger to this and other 
nearly tropical plants. Much has been done of late years to de- 
termine, by what are called isothermal lines, the mean heat of 
different points on the surface of the earth. It is found that 
starting from a point on the Atlantic coast, where the mean heat 
is 55°, and progressing westward on a line where the mean is 
always 55°, that this line almost constantly curves to the north 
or south, being governed by the laws controlling the distribiftion 
of heat, which are governed by various circumstances, such as 
oceans, seas, lakes, plains, plateaus, and great mountain ranges, 
or sometimes by those of lesser magnitude. Now, this isothermal 
of 55° on the Atlantic begins near the fortieth degree of latitude, 
and runs westward, but varies considerably southward, and crosses 
the Mississippi more than 1° south of the point of beginning, then 
slightly south of west until it arrives at the great plains, when it 
turns more to the south, so that when it reaches the 108th meri- 
dian, it is almost 37° north latitude. 

This increase of cold which bears it to the south so far, is 
caused, first, by the gradual elevation of the plains, and still 
more by the great altitude of the mountains, where it reaches its 
greatest southern curve. At this point it rapidly turns north- 
west, and arrives on the 118th meridian, 41° north latitude, and 
then turns nearly south, and when it arrives at the 28th parallel 
it is at the 123d meridian in the cold waters of the Pacific. 

In the Rocky Mountains these isothermal lines make numerous 



CLIMATOLOGY OF THE UNITED STATES. 99 

curves, "both to the north and south, caused principally by the 
elevation of the mountains. 

These observations on one isothermal line show that latitude 
does not accurately give the same amount of heat throughout its 
whole course ; neither do any other isothermals which exist. If 
we take the isothermal which begins on the Pacific coast at the 
fortieth parallel, or say the thirty-fifth parallel, where the jaiean 
temperature is 60°, and the meridian 120°, and follow it until it 
arrives at the 170th meridian, we shall find it on the fortieth par- 
allel ; and again, if we pursue this same line on the Atlantic coast, 
on the thirty-fifth degree of latitude, we shall find, when it reaches 
Spain, it crosses the fortieth degree, near Madrid, and before it 
reaches as far east as Rome, in Italy, it is found north of that 
city, or about on the parallel of forty-two and a half. From this 
point the line runs south of east, until it very nearly reaches 
the thirtieth parallel, and from thence in almost a direct line 
across Asia, and arrives on the eastern coast of that continent 
at about 32J° north latitude. This line which we have just traced, 
is much more direct in its course than any of the isothermals 
north of it. As a sample, take the 7nean of 32°, and it is found 
to begin a little south of the sixtieth parallel on the Pacific coast, 
and arrives at Lake Superior south of the fortieth degree of lati- 
tude ; it here turns north, and on the twentieth meridian east it is 
72J° north latitude. 

Now, this great difi'erence in the quantity of heat found at 
different points on the globe does not convey a just idea of the 
amount of heat or cold of any climate at different times of the 
year. The range of the thermometer is greater on continents 
than on islands ; and it is greater on the eastern shores of both 
America and Asia than on the western coasts of Europe and 
America. This great difference grows out of the fact that, on 
the western coast of North America there is a portion of the 
Pacific Ocean extending from the thirtieth to the fiftieth degree 
of latitude, or about 1,500 miles of latitude and 2,000 of coast, 
which is called the cold-water coast. Now, this portion of the 
United States lying on this coast has a temperature that varies 
very little during the year. This equable climate runs back to 
the coast range of mountains, and is, in winter, swept by south- 
westerly winds, and in the summer by north-westerly and west- 
erly. But the influence of these winds is mostly lost in crossing 



100 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

the coast range of mountains. The valleys of the Sacramento 
and San Joaquin lie between this range and that of the Sierra 
Nevada. These valleys are extensive and extremely productive. 
The heat at midday, and until three P. M., is intense in summer, 
the thermometer rising sometimes to more than 110°; but the 
nights, however, are quite cool, so much so that Indian corn 
can not be successfully cultivated, except in localities not very 
numerous ; and through the length of the coast of California, 
Oregon, and Washington, maize does not come to perfection, be- 
cause it must have a mean temperature of Q6°, whereas, on much 
of the coast, the mercury does not rise more than 60°, and gen- 
erally only to 57°. September, at San Francisco, is the hottest 
month, the thermometer varying but little night or day. 

It is now proper to compare the climate west of the Sierra 
Nevada Mountains with that lying east of that range ; and it may 
be as well to begin on the Atlantic coast, and return to the great 
interior plains and plateaus. In the State of Maine, at Holton, 
in June, 1838, the mercury rose, on the hottest day, to 98° 
and fell to 53°. At New Bedford, Massachusetts, the thermom- 
eter indicated, at its highest, 93°, and fell to 59° at night. This 
was the greatest height, with the exception of 1818, when it rose 
to 96°. This seems to have occurred but once in forty-four years. 
At Fort Columbus (New York city), the mercury rose twice in 
July, and once in August, 1838, to 94°. In the same year, it 
rose at Philadelphia to 96°. At Baltimore and Washington, in 
August, 1838, to 103°. In 1854 it rose at Charleston, in July, 
to 98°. It is singular that this is the greatest heat which oc- 
curred at that place during a period of 104 years. In Florida 
the greatest rise, from 1831 to 1854, was 100°; this took place 
in July, 1841. At Cincinnati, from 1838 to 1854, the mercury 
rose once in August to 106°. At St. Louis, from 1835 to 1855, 
the thermometer indicated six times 100° or more, being once 
107°. Fort Snelling, St. Paul, is situated at 45° north latitude. 
Here the mercury rose, in July, 1837, on one occasion, to 100°; 
and at six other times, from 1822 to 1854, it rose to 90°, or 
more, once being up to 96°. This occurred in the Junes of 
these years, but during the Julys of this period the mercury rose 
26 times to 90°, or over. It is said that the height of the mer- 
cury is as great at Chicago as it is at St. Paul, and that it some- 
times falls as low in winter. 



CLIMATOLOGY OF THE UNITED STATES. 101 

In the great interior plains of North America, the thermometer 
often, in summer, indicates 75° or 80° near midday; but the indi- 
cation at sunrise is frequently only 24°. In August, at the South 
Pass, it falls to 32° at sunrise, and rises at noon to from 70° to 
80°. There are, however, many places where the cold is not so 
great as above indicated, yet it is too great to allow of the suc- 
cessful cultivation of maize. As the foregoing facts sho^ that 
the heat of our summers is occasionally great, it is proper to 
give a few statements relative to the extremes of cold. 

At Holton, Maine, at least once every year from 1829 to 1845, 
the mercury ran down from 10° to 24° below zero. At New Bed- 
ford, Massachusetts, the mercury, during the period from 1812 to 
1856, fell below zero twenty times; once as low as 10°. This 
shows the influence that the ocean has on temperature. At New 
York, from 1822 to 1854, the mercury was below zero only four 
times, and but once three degrees below. At Albany, away from 
oceanic influence, the thermometer, between 1826 and 1854, fell 
often below zero. Indeed, in twenty-five years out of twenty- 
nine it fell from 2° to 23° below. But, falling back nearer the 
ocean, we find that at Philadelphia, during a period of fifty-eight 
years, the mercury was but seven times below zero; once it was 
as low down as 10°. At Washington, Baltimore, and Alexandria, 
from 1817 to 1856, the mercury only' fell below zero five times, 
and never more than 6°. At Charleston, South Carolina, from 
1750 to 1854, the mercury ranged from 15° to 48° above zero. 
The lowest was in 1791; the highest in 1848. The rise and fall 
of the mercury at New Orleans and Baton Rouge is nearly the 
same as at Charleston. It, however, fell at both of these cities 
to within 8° of zero in 1852. At Cincinnati, from 1835 to 1854, 
the mercury fell in seventeen of these years below zero, once 17°, 
but generally much less. It was, however, in January of 1852, 
down to 12°. 

St. Louis is remarkable for the great depressions of the mer- 
cury, for in February, 1835, it fell to 25° below zero. Indeed, 
in the period from 1833 to 1855, the thermometer often indicated 
depressions below zero. But let us take a point some six and a 
half degrees north of St. Louis, and we shall find a great differ- 
ence in favor of intense cold. ^ Fort Snelling, having long been 
a military post, the authorities early directed that the range of 
the thermometer should be recorded at that place ; hence we have 



102 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

a record from 1822 down to nearly the present time, though we 
have not the tables later than 1854. Now, within all this period, 
the mercury fell every year below zero, and on one occasion to 36° 
below. Even during March the thermometer is often below zero. 
Indeed, it would appear from the record that this point is, during 
winter, one of the coldest on the globe; yet we are advised to 
consider this one of the best places for the consumptive to spend 
the winter; but we shall see more of this by-and-bye. At Fort 
Brown, Texas, the mercury seldom falls more than two degrees 
below the freezing point in January and February. In 1850 it 
fell, in December, to 22°. At Fort Kearney it falls sometimes 
below zero 20°, but this is owing to altitude. At Fort Alamo it 
does not fall below the freezing point more than 13°. 

Let us now consider the importance of the amount of water 
which is precipitated in the form of rain and snow in the forma- 
tion of climate. Rain falls in greater or less quantities on almost 
every part of the earth's surface. The fall is, however, in very 
small amounts in some localities ; and large surfaces are fre- 
quently only visited by rain once in a long time, and some places 
never. Snow falls on the earth in the temperate and frigid 
zones, but never within the tropics, unless on very high mount- 
ains. As snow only falls during the colder months in the United 
States, with the exception of what falls on the peaks of the 
Sierra Nevada and the Rocky Mountains during summer, it, of 
course, has little influence on climate, further than to keep the 
range of the thermometer more steady during winter. This is 
not, however, the case with regard to rain. Where there is but 
little, we look for but few of the productions of the earth which 
go to the sustenance of animal life. And again, where very large 
quantities fall, especially in warm countries, vegetable life usurps 
nature's domain to the exclusion of animal life, except that kind 
of it which appears in the form of reptiles, or of wild and un- 
tamable animals. In the United States there is but little of this 
latter kind of climate ; but of the former, or arid kind, there is a 
great deal, as will be shown hereafter. 

It is necessary to show the importance of the amount of water 
that is precipitated in the form of rain, because it has a mighty 
influence on climate as to health and disease. If, in warm, coun- 
tries, little or no rain falls, the earth becomes heated to a degree 
beyond the comfort or even endurance of man, except in elevated 



CLIMATOLOGY OF THE UNITED STATES. 103 

regions. On the other hand, when the quantity of rain is very 
great, as in most parts of Brazil, and even in Louisiana, the 
climate becomes too unhealthy to admit of a dense white popu- 
lation; even the colored races seem to shun such localities. But 
in a temperate climate, as that of Oregon or Washington, a large 
amount of rain may fall, and yet the climate may be healthy, 
because in those northern countries malarious diseases ai»e not 
produced by exhalations from the earth's surface. 

In considering the disti'ibution of rain and snow in the United 
States, we shall first give a few facts with regard to the amount 
of precipitation on our Atlantic border and the eastern slope 
of the Alleghanies, and down into Southern Florida. At this 
last point about 63 inches fall annually. Proceeding from this 
locality to the northern part of the State of Maine, there falls 
during the year from 50 down to 40 inches; often between these 
points. Returning to the South, we find, from 85° meridian to 
97°, with its base on the Gulf of Mexico, and extending north 
to 40° of latitude, keeping close to the western foot of the 
Alleghanies, and on the west approaching within 2° or 3° of 
Fort Leavenworth, an immense region whose rain-fail is annually 
from 63 to 36 inches, and but seldom so low as 40 inches. 
The lower portion of this district has the greatest amount of 
rain, being from more than 60 to 55 inches, except on its western 
border, where there are only about 42 inches. At Memphis. 55 
inches fall; at Montgomery about 55 inches ; and at St. Louis and 
Cincinnati 45 inches. The latter city has 48 inches. North of 
40°, for two and a half degrees on the Mississippi, there are 42 
inches of rain fall; but east of this line, the fall of rain becomes 
less, at Chicago being only 40 inches. In Michigan, and a con- 
siderable portion of Upper Canada, the precipitation of rain and 
snow is but 30 inches. Indeed, the whole of the lake region has 
but from 30 to 36 inches, very little of it being up to 36 inches. 
At Cleveland there are 36 inches, and so down the lakes and 
to the mouth of the St. Lawrence. In the valleys of the rivers 
which flow into the St. Lawrence, on the north, but 34 inches fall. 
In the country in which Pittsburg is situated there is only a fall 
of 36 inches. This extends .for some distance around from 
Cleveland east, running far east of Pittsburg, and, turning south- 
west, terminating in the mountain region of the Alleghanies, about 
the 35th parallel, Pittsburg being left close to the inner curve. 



104 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

We sliall now take a view of the vast regions lying west of 
a line drawn from the mouth of Rio del Norte, to the western 
shores of Lake Superior. This line touches or runs near Forts 
Gibson, Leavenworth, and Snelling. On it about 30 inches of 
water fall, in snow and rain. Now there is no place west of 
this line, with a single exception, until the Sierra Nevada 
Mountains are reached, where there are 30 inches of rain and 
melted snow-fall during the year. The belt on which this line 
is fixed, however, extends in two places about a hundred miles 
west of it. Then the other exceptions occur between the 104th 
and the 107th degrees of longitude, and the 35th and 40th 
parallel. In this region there is about 30 inches of precipita- 
tion. In all the great plains of the interior, until the Rocky 
Mountain range is reached, there are only from 10 to 20 inches 
of precipitation. It only falls as low as 10 inches on the 
Peace River, a branch of the Rio del Norte; then, between the 
40th and 45th parallel, 15 inches fall. Again, on the Upper 
Missouri, comprehending the Yellow Stone, etc., there are 20 
inches. Along the Rocky Mountain range there are from 20 to 
25 inches precipitation, mostly in snow, we presume. Between 
the Rocky Mountains and Sierra Nevada we find, in the valley 
of the great Colorado River, from 3 to 5 inches, mostly in the 
southern portion; and further north, or north- wes't of the Great 
Salt Lake, there are only from 10 to 15 inches, there being 20 
inches around the lake. 

West of the Sierra Nevada range the amount of rain and snow 
is very diiFerent at the north from what it is at the south. There 
is a district of country beginning on the Pacific coast, and ex- 
tending far north of the limits of the United States, which, at the 
50th parallel, is 5° of longitude wide, and runs south to the 40th 
parallel, in a wedge shape. This district, on its coast margin, has 
a rain-fall of 65 inches through a space of 7° of latitude; south 
of this, 55 inches, then 45, and then 30 inches, which is at 
its southern termination. This rai-n-belt crosses the first and 
second range of mountains. It throws ofi" -a branch at the 40th 
degree along the Sierra Nevada, which terminates on the 35th 
parallel of latitude. On its eastern side the amount of precipi- 
tation is considerably less than on the western, being from 30 to 
45 inches. 

About 2° south of the wedge-shaped space mentioned, is the 



CLIMATOLOGY OF THE UNITED STATES. 105 

city of San Francisco. Here but 22 inches fall ; and further 
down, on the 30th degree of latitude, but 10 inches fall. 

It is a matter of importance to know the amount of rain which 
falls at different seasons of the year, as the amount falling during 
the latter months has a decided influence on health or disease. 
We shall first take a view of the amount which falls during the 
spring. 

On the whole coast of the Atlantic, up to the crest of the 
Alleghanies, every-where about 10 inches of rain and melted 
snow fall during the spring. Around the southern margin of 
the great lakes only 8 inches fall;, then, again, north of this 
line — taking in much of Lake Michigan, nearly all Lake Huron, 
and all the country west for many degrees of longitude, and 
being some 2° in width — only 6 inches fall. In this belt St. Paul 
is situated. North of it, to an unknown extent, but 5 inches 
fall. South of these localities, clear to the mouth of the Mis- 
sissippi, the rains are more copious, being in the northern part 
about 10 inches ; and after getting to the mouth of the Ohio, there 
are from 13 to 15 inches; for in all the country on the lower Mis- 
sissippi this amount falls, including nearly all Alabama, most of 
Georgia, and a great part of Tennessee ; and on the west there are, 
south of the Red River, and west of the Mississippi to nearly the 
one hundredth degree of longitude, from 10 to 12 inches. 

In all the country west of the 98° or 100° of longitude, there 
are from 1 to 15 inches. The part where 15 inches fall is on 
the Pacific coast, north^f the 40th parallel. In the valley of 
the great Colorado there is not 1 inch, and on the great interior 
valley the amount ranges from 2 to 5 inches. On the great 
plains east of the Rocky Mountains, and west of 100° of lon- 
gitude, there is a rain-fall of 5 or 6 inches. All the Upper 
Missouri, north of the 45th parallel, has a rain-fall of but 5 
inches. 

If we now turn back, we shall find an increase of precipitation 
during the summer at many points, while at others we shall find 
a decrease. In all the country east of 98° of longitude there 
is nearly every-where an increase of rain-fall, and a great in- 
crease to the south. In central Florida 25 inches fall during the 
summer. At New Orleans and Mobile 22 inches fall; and all 
along the Atlantic coast, back to the mountains, there are in the 
south 15 inches ; farther north, from 14 to 10 inches. In the 



106 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

valley of tlie Mississippi there is, too, a general increase over the 
precipitation in the spring; even round the lakes from 9 to 10 
inches fall. But, alas ! when we get west of the one hundredth 
meridian, this profusion of rain ceases. Between the one hun- 
dredth and one hundred and fifth there are generally but from 3 
to 4 inches of rain, except in the extreme south portion of this 
belt. West of 95° of longitude, the Bocky Mountain range has 
a fall of rain and snow of from 6 to 10 inches. Then, in the great 
interior valley there is sometimes no rain — often half an inch, or 
from 1 to 2 inches. In the Sierra Nevada Mountains the fall 
of rain is very small; and on the whole western part of Califor- 
nia, from the 30th to the 40th degree of latitude, there never is 
any rain during the summer. From the 40th to the 50th degree 
of latitude there are from 1 to 4 inches. In the autumns of this 
same region there falls from 1 to 3 inches, up to the 40th par- 
allel; then it increases north from 5 to 15 inches. The Interior 
Basin has only from 2 to 3 inches. The Rocky Mountains have 
but from 5 to 6 inches, and from these mountains to the 100th 
meridian, there falls, in general, from 3 to 4 or 5 inches. 

During the winter there are some curious changes in the 
amount of precipitation in rain and snow. On the Atlantic 
coast the amount of precipitation is nearly the same as in 
autumn, with the exception of Florida, where there are but 6 
inches. And then up the coast there is a belt, not far from one 
hundred miles wide, where only 8 inches fall. If we now pursue 
the valley of the Mississippi, from the ^ulf to the 40th parallel, 
there is but little difference in the amount of precipitation from 
that of autumn; there is, however, in some places, a little more. 
But when we pass the 40th degree, we find, south of the lakes, 
where in autumn there were from 8 to 10 inches, that in winter 
there are but from 5 to 7 ; and north of the lakes 5 inches is all 
that there is. Most of this must, of course, be snow. Both above 
and below Lake Superior, however, there is a belt at the north- 
ern end, or side, taking in all this great lake, extending from the 
80th to the 90th degree of longitude, and running irregularly to 
the south, reaching the Rio del Norte about the 103d meridian. 
This whole belt of country has only a rain-fall of 3 inches. Fort 
Leavenworth and Fort Gibson are in it. The lower part is much 
narrower than it is at Lake Superior. From the termination of 
this belt to the 109th meridian at the north, and coursing some 



CLIMATOLOGY OF THE UNITED STATES. 107 

five degrees east, it terminates close to the SOtli parallel, in a 
point. This whole space has not a rain-fall of more than 2 
inches during the winter. 

The Eocky Mountain region now begins, and takes in about 5 
degrees of longitude, but not running directly north. This vast 
mountain range begins in the Black Hills, about the 98th merid- 
ian, and terminates at the 120th. At the 50th parallel, -s^jthin 
this space, there falls from 4 to 5 inches. The Great Basin of 
the interior has from 1 to 3 inches ; but from the 43d parallel to 
the 47th — the Snake River country — is not included within the 
Great Basin, but is equally barren and destitute ^of rain. 

Washington Territory has, near the coast, 30 inches north, and 
20 a little south. Oregon has 15 inches. Below the 40th paral- 
lel, and to the 35th, then west of the Sierra Nevada range, from 
7 to 10 inches; and for several degrees lower down there is a 
fall of 7 inches. There is a large space on the great Colorado 
River where there is no rain during this period. 

The reader may, after perusing the foregoing pages, come to 
the conclusion that North America, or at least that the United 
States, has a very large amount of country which is without suffi- 
cient rain for the purposes of agriculture. This is, indeed, true; 
but the eastern hemisphere, north of the 20th parallel, has a 
much larger space, which has no more rain-fall than the western 
part of the United States, and a much greater one that is rain- 
less. England and Ireland have about 40 inches of rain-fall; 
Scotland less. Paris has but 20 inches; Berlin nearly the same; 
and Vienna but 18 inches. There is, on the great plains of Asia, 
but 10 inches of precipitation. In China and the East Indies 
there is generally a large amount of rain. Both in the eastern 
United States and China there is, in the general, a better dis- 
tribution of rain than elsewhere in the same latitudes. 

We shall now take into consideration the surface of the 
United States, both as regards its marshes, plains, alluviums, un- 
dulations, and mountain ranges. We shall first consider the 
Alleghany or Appalachian Mountains, which rise in Georgia and 
Alabama, running north-east through 20 degrees of longitude, and 
about 12 degrees of latitude. Their height varies considerably 
at different points. The Black Mountains of North Carolina are 
the hio^hest in the rano;e, unless the White Mountains of New 
England be considered as a link in the chain, as we presume they 



108 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

should be. These mountains are nearly 7,000 feet high, and 
those of North Carolina more than 6,500 feet; but, in the general, 
this mountain range does not reach 3,000 feet above the level of 
the sea. Yet these mountains do not have much influence in 
altering the course of the winds nor the temperature of the At- 
lantic coast. But more of this by-and-bye. 

The great interior valley of North America, which Professor 
Drake has so ably written upon, and so laboriously examined, is 
vast in extent and productiveness. It is bounded on the east by 
the Alleghany Mountains, on the west by the Rocky Mountains, 
and extends in the United States from the Gulf of Mexico to the 
great lakes on the north. Now all this vast region is one immense 
plain. No mountain is projected through it. To the north-west 
the Black Hills, and in the center the Ozark Mountains, push some 
distance into it; but they are only about 2,000 feet high, so that 
its climate is but little affected by them. On the western border, 
about the 100th meridian, that mighty barrier, the Rocky Mount- 
ain range, rises, which extends its whole length from north to 
south. The altitude of these mountains averages 10,000 feet 
above the level of the sea. West of this range of mountains 
comes the great interior basin, or great plains, stretching to the 
Sierra Nevada Mountains. This immense space contains about 
500,000 square miles, and is elevated from 2,000 to 7,000 feet 
above the level of the sea. The Sierra Nevada Mountains rise 
about as high as the great range east of them ; and beyond these 
there is a coast range, which is much lower, but sufficiently high 
to have considerable influence on the climate in the valleys east 
of it. Now, on the surface of these great plains west of the 90th 
meridian, and along the Missouri and the heads of the Red River 
of the north, saline lakes and marshes and alkaline effervescences 
are frequent, particularly at what are called the bad lands, which 
name is apphed to many parts of the great arid interior plains 
inclosed by the northerly bend of the Missouri, and extending 
nearly down to the Platte. 

The distinguishing plant of these soils is the artemisia, or wild 
sage, which begins sparsely at the edge of the plains, and be- 
comes more abundant near the mountains, and covering the arid 
plains beyond them with a dense and almost exclusive growth. 
These arid plains are covered with this family of plants, from 
near the 100th meridian to the Pacific coast, as is noticed by 



CLIMATOLOGY OF THE UNITED STATES. 109 

Fremont and others, who have traversed it in various directions. 
Further south, plains of salt and gypsum occur not far from the 
Arkansas Riv^er, about the 90th meridian; and near the Red River, 
in upper Texas, the artemisia, with varieties of cacti, appear. 
The sage occupies a space, from north to south, of 25° of latitude. 
In this way are these vast deserts covered with the lower forms 
of vegetable life. It is not difficult to see that but a sparse and 
not a very civilized race of men will ever occupy a country so 
unfriendly to agriculture, and to most that tends to make society 
prosperous. These observations do not apply, however, to the 
Pacific coast, and to the country north of the 43d parallel and 
■west of the 98th meridian, for in these vast regions mankind 
are destined to intellectual and physical developments probably 
equal to any that may have occurred in the world. 

We now must consider the influence which the surface of the 
United States has in the production of health or disease, and, 
also, what influence the winds have in these respects; those 
causes of diseases incident to districts producing malaria, as 
well as those which favor inflammatory afi'ection, and continued 
fevers. 

The low districts of the south Atlantic States have all the 
requisites necessary to the production of miasma, for the rivers 
there " spread very much in lagoons and shoals, and rarely enter 
the sea by deep-water channels;" and north of these localities we 
find, almost constantly, marshes, swamps, etc., which are equally 
favorable to the production of this poison, until we arrive at 
Long Island Sound, for in the vicinity of New York remitting 
and intermitting fevers are common; so, too, at other localities 
south of that. In early times, these diseases were even found 
in the valley of the Connecticut River. On this low margin of 
the Atlantic coast it will ever be an impossibility to successfully 
rescue it from the production of diseases growing out of miasma, 
the production of these swampy localities. But to return for 
a moment to the south. We find in Florida thousands of square 
miles of swamp land; the same is the case with eastern Geor- 
gia, and large portions of South and North Carolina, etc. Those 
unfortunate human beings whose destiny has been cast amid 
the exhalations of those vast swamps, grow to manhood with 
slender frames, but often tall. They have prominent abdomens 
and attenuated limbs, with sallow and bloated features; they 



110 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

move slowly, talk in a drawling manner, and mostly have re- 
mitting or intermitting fever some part of every year. Their 
energies are feeble and their lives short. When these cil^atures 
remove to more healthy districts in the West, they "nearly always 
cease to have malarious fevers. We have known people from 
situations where ague did not exist remove to these localities and 
take this disease — a curious fact, But we must now consider the 
Mississippi Valley, which has long been considered the hot-bed 
of malarious fevers. The great alluviums of the lower part of the 
valley are very extensive ; and as we pursue the Mississippi north, 
we find immense bottoms, until w^e reach St. Louis. Still higher 
up on this river we find extensive alluviums and lagoons; while 
in addition to these sources of malaria on the main stream, the 
tributaries give vast additions. There is the Red River, two 
thousand miles long, with the Arkansas, the White River, and 
Missouri, on the west, which have immense low grounds on their 
margins that are frequently overflowed during floods. The val- 
leys of all these rivers are well known to be unhealthy, and for 
long distances have lagoons and swamps which never dry. The 
Missouri, indeed, one thousand miles from its mouth, loses, in 
a great measure, its malarious bottoms; so do some or all of 
those mentioned. On the east side of the Mississippi, the Ten- 
nessee, the Ohio, and Illinois have many unhealthy spots in their 
valleys. On these malarious diseases principally abound. Now, 
not only these great bottoms produce bilious fevers, but many 
of their small tributaries which drain the rich prairies of Illinois, 
Missouri, etc. Even the numerous affluents of the Ohio, which 
drain the western slopes of the Alleghanies, have alluviums suf- 
ficiently large to give origin to these diseases occasionally. 

It is conceded by all writers on the subject, that autumnal 
fevers are often intense on the bottoms of all the Southern rivers, 
and but little less severe on many of the lime-stone lands of 
the State of Mississippi and those of other States south; but all 
likewise admit that, as we travel north, those diseases gradually 
diminish in severity and in frequency, until they eventually dis- 
appear about the 47th parallel. Malarious diseases were once fre- 
quent on the lowlands of the rivers falling into Lake Erie; but 
they have diminished of late years, though near the lake they still 
exist with their wonted virulence, or nearly so. Throughout the 
valleys, wherever the bottoms do not overflow, a constant lessen- 



CLIMATOLOGY OF THE UNITED STATES. Ill 

ing of these fevers is the consequence. The great alluviums of 
the Mississippi are overflown every year, and frequently leave 
ponds and lagoons, which constantly engender those vapors that 
produce fever. Of course there is but httle hope of the destruction 
of these causes. Many who live in malarious situations enjoy good 
health. They claim that they live in the most healthy part of the 
world. 

It is proper we should notice those parts of our country 
which are either so much elevated and uneven, or so thin or sandy, 
that no stagnation of water occurs, Where these districts lie 
very near, or are bounded on the west, south-west, or north-west 
by malarious grounds, the inhabitants may have remitting or 
intermitting fevers. It would appear that where dry and undu- 
latory plains without timber are situated, as above stated, and 
malarious marshes or swamps are extensive, that bilious fevers 
may be produced for many miles by the poison carried by the 
winds. Aside from this, dry and elevated countries are very 
seldom infested with these fevers. There is one decided excep- 
tion to this; that is in the auriferous regions of California, and 
also in the great valleys of that State. Dr. Black insists that 
the atmosphere is malarious, notwithstanding the total absence 
of swamps and marsh lands, and that the hypothesis that heat 
and moisture and vegetable decomposition are necessary to the 
production of remitting and intermitting fever, is not founded 
in fact, and is wholly untenable. He cites his own experience 
in the gold regions, where he arrived long after the rains had 
ceased, and remained while there was neither rain, dew, not 
fogs. Yet he had to encounter, with others, long-continued 
intermittents, although neither he nor his friends had ever be- 
fore suff'ered from any similar disease. In the day a continued 
wind from the Pacific prevailed, and at night winds from high 
and snow-capped mountains. In this situation there was not the 
least possible chance for vegetable decay. But is it not right 
to charge most of these to direct importations from the Isthmus, 
and many to dormant malarious impressions which only need 
hot days and cold nights to develop them? for it must not be 
forgotten that malaria implants in those subjected to it a dis- 
position to bilious fevers of a remitting or intermitting kind. 
On this point there have been many mistakes made by physi- 
cians and writers, who generally labor under the impression that 



112 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

this poison soon develops itself after having made its lodgment 
in the system. Now, we have often known cases where the sub- 
ject had been exposed to malarious influences, and the remitting 
or intermitting fever has not occurred for three months, or even 
longer, afterward. It seems that fever is very common in Cali- 
fornia, and probably further north. Much of it is probably of 
a continued type, and, from some statistics which we have seen, 
w^e should think fatality is frequent. There is one matter that 
must be taken into account when considering the causes of fever 
in that State; that is, that' the winters there are the periods of 
the greatest rainfall, and then is the time when vegetation flour- 
ishes, as well as in early spring, at which season the growth is 
immense, and continues so until late in April, when all at once 
the rains cease ; and then comes a sudden decay of vegetable life, 
both of the present and former year. Decomposition during a 
few weeks takes place, and then all is dry, with great disparity 
of heat between night and day. Then why should not remitting 
and intermitting fevers come? Why should not the surface 
exhale the particular poison w^hich produces these fevers? We 
think that it is pretty plain that such may be and is developed. 
Those living in such a situation would not at once, but within a 
few weeks, or longer, be subjected to them. 

Ague and fever, says Blodget, blends every-where with locali- 
ties of the deadly miasm. The destruction of the British army 
in the Netherlands, in 1809, is ascribed to ague alone. At Bor- 
deaux, in 1805, says Johnson, 12,000 were seized, and it proved 
fatal in 3,000 cases. As understood in the United States, such 
results could hardly ensue, as ague is usually, if not univer- 
sally, taken to be a curable disease, and fatal results are but sel- 
dom. This disease is epidemic over the Netherlands and Lower 
Germany ; and generally over alluviums and river valleys, with 
marshes and stagnant water, in all parts of Europe south of these 
points, and in some locahties north of them. 

Those districts or regions which are not subjected to malarious 
diseases we must now take a view of. The amount of these 
are very extensive. First, nearly all New England; much also 
of the State of New York; all, or nearly all the Alleghany range 
of mountains, with long distances on each side, particularly on 
the west side, seem to be nearly clear of malarious diseases. 
The rivers and smaller streams penetrating these mountains fre- 



CLIMATOLOaY OF THE UNITED STATES. 113 

quently have bottoms on their margins which give origin to au- 
tumnal fever. There are, in some situations, plateaus on the tops 
of these mountains, which are either wet or swampy, where these 
fevers occur. 

The writer knows well, from experience, that for a long time 
after the first settlement of the country, physicians considered 
all fevers that occurred on the slopes of the mountains as bilious, 
and so called them; and it was not till some time about 1842 
that the fevers of these localities were recognized as continued or 
typhoid in their character. Now all countries situated as those 
parts of the United States which have no marshes, swamps, stag- 
nated waters, or extended flat and wet lands, and holding surface 
water, are subject to these continued and inflammatory fevers. 
These diseases must predominate in Oregon and the country east, 
until we reach below the 42d parallel on the Mississippi, except 
in some sparse localities; and for long distances south of this, 
in the great interior basin, and mountain ranges west and east 
of these interior plains, as well as those east of the Rocky 
Mountains. 

Our observations would not be complete unless we take into 
consideration the course of the winds, and their influence on the 
climate of our country. 

In all countries the winds are acknowledged to have a great 
influence on their climatology. The ancient Greeks had a temple 
dedicated to the winds, with statues showing by their attitude- 
winds from certain points to be either severe or mild. It must^ 
however, be admitted that the atmosphere has in itself no power 
of this kind, unless other agents act on it. The great agent is 
heat. Air expands by heat, and becomes lighter; it rises from 
the earth, and that which is colder and more dense expels that 
which is light. These facts are constantly occurring on the 
earth's surface, either in a lesser or greater degree. It takes 
place in our heated rooms, in our cities, in deep ravines, where 
the atmosphere is still, and the sun throws his rays against the 
declivities on either side, and on the heated plains, causing gentle- 
breezes, or severe winds, storms, or tornadoes. Within the tropics 
these demonstrations often appear upon a grand and fearful scale. 
The atmosphere is thus kept constantly in motion, unless where 
calms occur. Mountain ranges, broken country, and forests check 
the velocity of the winds. Their course is often turned from 
8 



114 AMEEICAN HOUSEHOLD BOOK OF MEDICINE. 

a direct line by these causes, which however, only act on the sur- 
face winds of the globe, for the higher strata of the atmosphere 
do not seem to be much turned from their onward course by 
these surface obstructions ; hence the higher currents of the at- 
mosphere in the north temperate zone seem to pursue their course 
eastward, leaving the lower strata to be controlled by the irregu- 
larities of the earth's surface, or by the electrical and calorific 
influences which display themselves. When the atmospheric cur- 
rents pass over extensive plains, oceans, or even low mountain 
ranges, like those of the Alleghanies, the upper strata carry the 
lower with them, often for long distances, as the western winds 
sweep from the far west, cross the Alleghanies and Atlantic, 
only being exhausted after passing far into or over the European 
continent, rendering the northern and western part of that con- 
tinent more temperate. 

The barriers formed by the Rocky and Sierra Nevada Mount- 
ains rise so high that the winds near the surface of the Pacific 
find the obstructions to their eastward progress so interrupted 
that they never reach the plains east of those mountains. At 
the passes of the Sierra Nevada range, and in all the entrances 
from the Pacific to the interior districts and deserts, there are 
continued and violent winds from the west. In many places the 
abrasions found in the rocks have been caused by these winds. 
The rocks and clay surfaces have cavities and traces worn in 
them in parallel lines, like the abrasion of rocks caused by the 
transportation of rocks or ice ; and by the resistance thus made, the 
surface winds are exhausted on their way across the great desert. 

Let us consider for a moment the' course of the winds below 
the o5th parallel down to the tropics. This space is occupied, 
on the land, in the United States, by irregular winds, monsoons, 
calms, and winds undefinable — that is, belonging to local and 
peculiar causes and systems. It is a district of great difficulty 
in examination, the contrasted .surfaces of land and water pro- 
ducing sea breezes, as well as limited coast monsoons. There 
are still greater causes of irregularity to which the great mon- 
soons are due, and the peculiar winds of Texas, of the lower 
■Mississippi Valley, and of California, are of this character or 
origin. It is probable, and even more than probable, that the 
north-westerly winds that sweep the coast of California, and ren- 
der it so cool during summer, are produced by the heated winds 



CLIMATOLOGY OF THE UNITED STATES. 115 

from the plains of Mexico, which exhaust themselves on the great 
interior plains ; and then the south-western winds reach the same 
coast during the cooler months, bringing with them heat and 
moisture, which favor the productiveness of that country. 

In New Mexico the disturbances of the atmosphere are very 
irregular, and when they descend, to Texas they are entirely 
changed. They there blow from the south-east during one hun- 
dred days, and from the south sixty, but only twenty-five days 
from the west and twelve from the north. These movements of 
the atmosphere give a great preponderance to the south-eastern 
and southern winds, and, of course, gives them an important in- 
fluence on the climate of that State. 

In the Mississippi Valley the southern and south-western winds 
predominate from April to October. In the other months, above 
the 35th parallel, western and north-western winds have the pre- 
dominance. At Cincinnati, it is shown by that careful observer, 
Dr. Ray, that during sixteen years there was an average of winds 
as follows : Eighty days from the south-west, ninety-five from the 
west, and, from the north-west, fifty-five. These, of course, con- 
stitute the principal winds. They have, however, occasionally 
atmospheric currents from the north-east, but from the south sel- 
dom. During the sultry summer of 1865, and in September, the 
winds from the south were more prevalent than usual at Cin- 
cinnati. The south winds are mostly exhausted south of that 
point. To the north-west, we find, at Fort Snelling, Fort How- 
ard, Green Bay, and at Fort Brady, Michigan, that the north- 
westerly winds greatly predominate, being from one hundred and 
sixty-five to two hundred and nineteen days in that direction. 

There is but little difference in the direction of the winds on 
the eastern slope of the AUeghanies from those of the western. 
The severe disturbances of the atmosphere on the Atlantic coast, 
from Florida to Maine, are felt nearly to the base of those 
mountains; but they are much more severe near the ocean than 
farther inland. These severe currents on the Atlantic are fre- 
quently equaled by the blows and storms on our great lakes. 

It may be proper to consider briefly the history and nature 
of storms, hurricanes, and tornadoes. All countries are, more or 
less, subject to these atmospheric convulsions; but the eastern 
parts of the United States are especially amenable to such 
violent disturbances. This is particularly the case the nearer 



116 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

■we approach the tropics. Indeed, some of the most violent which 
have anywhere occurred, have been in the lower part of the Mis- 
sissippi Valley, and they extend often as high as the lakes, and 
there do much damage. They are almost always accompanied 
with rain in the south, and with snow, or snow and rain, fur- 
ther north. These disturbances of the atmosphere are brought 
about by the same general causes which excite the movement of 
the winds, but these operations of heat, electricity, etc., are 
greatly intensified in the production of storms. Storms travel 
at the rate of twenty-five or more miles an hour, and are gen- 
erally from the west or north-west, and continue in this direc- 
tion until they reach the Atlantic, when they curve to the north- 
east, to accommodate themselves to the isothermal lines. These 
observations apply to the winds north of the 35th parallel. South 
of this severe general storms occur, but difi*erent in their move- 
ment. In Texas they are called northers, and take place often 
along the whole coast of the Gulf with great severity. In winter 
they here move eastward, but not in other seasons. These 
storms, above the 35th degree, do not originate in the Rocky 
Mountains, but on the eastern side of the great plains, about the 
98th meridian. At their beginning they do not precipitate much 
rain or snow, but as they advance east this precipitation increases, 
and sometimes, in the country west of the Lakes Michigan and 
Superior, there is a fall of about a foot of snow, or enough to an- 
swer all the purposes of travel by sleds. But to return : We find, 
as we progress eastward, that there is an increase of snow until 
we reach the State of Maine, which increase does not seem to 
diminish until the ocean is approached. The snow in these 
Eastern States generally averages about 60 inches in its loose 
state. New Hampshire has about 68 inches, and at Burlington, 
Vermont, 85 inches fall; but in Massachusetts the quantity is 
only 54 or 55, when at Cincinnati there is only an average of 
16 inches each year. 

The quantity of snow which falls south of the 41st degree of 
latitude is very uncertain. The storms accompanied with rain 
or snow precipitate these often rapidly, and the wunds are fre- 
quently severe. This, however, is not so much so in the Mis- 
sissippi Valley as it is east of the Alleghanies and south of the 
degree above mentioned. Snow lies generally but a short time 
on the ground ; indeed, often melts as its falls, or immediately after. 



CLIMATOLOGY OF THE UNITED STATES. 117 

West of the 98th meridian there is but a slight fall of snow 
until we reach the R-ocky Mountains, where there is precipitated, 
during the colder months, 10 or 12 feet of loose snow; and, 
again, a considerable amount in the Sierra Nevada range, but 
there is but little on the interior plains. 

During the warmer months of the year, there are rain-storms, 
and occasionally hurricanes, near their center; and within these, 
once in a while, tornadoes. These hurricanes often do much 
damage by destroying forests, and scattering fences to the four 
winds, and but too often cause the destruction of houses and 
barns, while human lives are occasionally lost. Such hurricanes 
are frequently several hundred miles in width, and travel from 
forty to eighty miles an hour — the latter speed renders them 
very dangerous — sweeping down nearly every thing in their way. 
Tornadoes are still more fearful in their consequences. They 
are composed of one or more whirlwinds, which extend in width 
from thirty to two hundred rods. In this space they travel so 
rapidly, and do their work so quickly, that no prudence can 
avoid the consequences. The travel of these hurricanes and 
tornadoes is always from west to east, or nearly so. 

Those storms which travel our great lakes very often do much 
damage to the shipping, and render navigation especially danger- 
ous during the two latter months of autumn, and again during 
the months of March and April. These lake storms do not 
appear to be more severe than on the Atlantic coast. The 
country on the lake borders, and for some distance interior, is 
swept by these severe blows which make it an unfit abode, dur- 
ing the colder months of the year, for patients laboring under 
bronchial or tubercular disease; this is, however, equally true of 
the Atlantic border. 

It must not be forgotten that the great prairie regions of the 
interior valley, as well as the treeless plains, deserts, etc., west 
of them, have often continuous winds that frequently last through 
several days, but are, during the warmer months, pleasant and 
often delightful. In winter and spring they are severe, and not 
easily endurable by invalids with bronchial affections. 

The question now arises where the best points in this extensive 
country exist for the invalids laboring under various maladies 
to visit or reside in. In general, invalids feel and do best in 
parts where the humidity of the air is but little, and where rain 



118 AMEEICAN HOUSEHOLD BOOK OF MEDICINE. 

is unfrequent. As a general rule, the rain-fall in the northern 
situations is not so great as in those further south; but in the 
north the fall is slower, and there are more cloudy days; so 
that, really, the invalid suffers frequently more from these slow 
precipitations than where rains fall heavily and are followed by 
clear skies. For instance, the pine woods of Florida, of Louis- 
iana, and other parts of the south, where there are* no swamps 
nor rich alluviums, but deep sand, patients laboring, under ma- 
larious diseases do as well in them as they would in similar 
situations north; and where these localities lie moderately high, 
those worn out by these diseases may, with great propriety, be 
advised to repair to them for the recovery of their wonted health. 
Then these patients may be again directed to high situations in 
the north during the summer. Most of New England can be 
visited with advantage by patients whose health has been broken 
by autumnal fevers, and they may make their home there with 
benefit. So, also, will they be benefited by visiting almost any 
part of the Alleghany range, and in all situations on their eastern 
or western declivities, until level plateaus and swamps occur. 
Hence, the rolling and hilly country down to the Ohio River 
may be chosen, and even on the west side of it, for some thirty 
miles, to a point below Louisville. This distance is sometimes 
much under thirty miles, but often over. Care must always be 
taken to live away from low bottoms and stagnant water. On 
the eastern slope of these mountains there is a large and healthy 
race of men produced, who seldom or never suffer from malarious 
diseases. Of course all these localities are proper for the resi- 
dence of invalids who wish to get rid of the influence of malaria ; 
but patients wishing to get clear of all malarial effects in a short 
time, should visit the Upper Mississippi, at and above St. Paul, 
or they may explore the upper country on the Missouri, and 
visit the great plains bordering the Rocky Mountains down to 
Texas. Even New Mexico could be traversed Avith advantage. 
Then, again, the Lake Superior region is among the best for a 
summer residence. Probably the Island of Mackinaw is as de- 
lightful a place as can be chosen for a summer resort. " There," 
says Dr. Drake, "the three great reservoirs of clear and cold 
water — Lakes Huron, Michigan, and Superior — offer a delightful 
hot-weather asylum to all invalids who need an escape from 
crowded cities, paludal exhalations, sultry climates, and officious 



CLIMAa:OLOGY OF THE UNITED STATES. 119 

medication. Lake Erie lies too far south, and is bordered with 
too many swamps, to be included ih the salutiferous group." 

There can be little doubt that the immediate coast of Califor- 
nia is one of the very best locations for a summer residence for 
invalids, not only of this, but of any other continent. There the 
temperature is always equable, and there is no rain. The time is 
fast hastening on when this locality can be reached by raiFin a 
few days, which will give the worn-out city inhabitants the oppor- 
tunity of visiting it, and of being cured of their headaches, their 
want of appetite, and their debility. 

Bat we have to consider for a moment the proper place for 
the consumpted, and for those in general who have contracted 
disease in what are considered our most healthy districts of 
country. The acute forms of them are not likely to be benefited 
by removal, but chronic inflammations can often be benefited by 
a .change of climate. Of these may be mentioned chronic in- 
flammation of the bronchia, and chronic rheumatism, with various 
other chronic afiections of the nervous and secretory organs. 
Patients laboring under consumption of the lungs, or tuberculosa 
of a more general character, or with scrofula in any form, should 
visit California, if w^ithin their power. There is, however, a wide 
difi'erence of opinion among physicians with regard to what places 
patients should be advised to resort who labor under consumption 
of the lungs, or scrofula in general. Some think that a dry north- 
ern climate should be preferred, and even insist that such in- 
valids are benefited by spending their winters, in regions like that 
of St. Paul. That many patients have been much benefited by 
visiting and spending their winters there, there' can be little or no 
doubt, but still less of spending their summers in that locality, or 
in localities higher up the Mississippi or Missouri rivers. These 
physicians are pleased when their patients choose Dacotah, or even 
do not object to their going still further west on the same par- 
allel. But we believe that a majority advise a southern climate 
in preference; hence New Orleans and other parts of the South 
are recommended for winter residences. Western Texas is some- 
times favorably mentioned, and, no doubt, with great propriety, 
as a proper place for winter residence. There but little rain falls, 
and the only winds that are unfavorable are northers, which last 
but a few days at a time, and come but seldom. Many parts of 
Florida, also, are delightful during the winter, as the climate is 



120 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

warm, and during the winter there is but httle rain. But of all 
the countries on the globe, California is probably the most favora- 
ble for those laboring under consumption. If it does not cure it 
mitigates the horrors of this dreadful disease, and seems often to 
stop its progress for considerable periods. The southern part 
of California is the most favorable for these patients. It seems 
to be clearly proven that there are not more than one-third as 
many cases of consumption in this Pacific State as there are in 
New England, in proportion to the number of inhabitants. New 
Mexico is favorable to patients with breast complaints; so is 
Mexico ; and we presume that all the warm countries of South 
America, where there is but little rain and not much elevation, 
would be a boon to Northern patients. We presume that Chili, 
near the coast, has a climate that would benefit the consumpted 
nearly as much as any other. There is one thing which takes 
place occasionally with patients who labor under consumption, 
that has advanced into the second stage, or where softening has 
begun in the tubercles ; that is, that when they remove to a ma- 
larious locality, where autumnal fevers prevail, and take either 
remitting or intermitting fever, the softening of the tubercles is 
apt to occur, and cause the patient to die in a comparatively 
short time; therefore patients thus diseased should avoid all very 
malarious situations. And, again, consumpted patients, and those 
affected with bronchial disease, should avoid living on the shores 
of our great lakes. The severe winds which are so frequent 
there are the sources of much bronchial disease, and, of course, 
will hasten the fatal march of consumption. These remarks will 
apply equally well to the cutting winds on the Atlantic coast, 
especially its northern portion. 



MINERAL WATERS. 121 



CHAPTER III. 

MINERAL WATERS. 

These may be arranged into the following classes : Alkaline 
Waters, Acidulous, Chalybeate, Sulphureous, and Saline. 

Alkaline Waters owe their properties to a free alkali, or, it may 
be, one slightly carbonated. An alkaline reaction is made sensi- 
ble by the proper and usual tests. 

These springs are rare. They contain carbonate of soda and 
carbonic acid, and are almost entirely free from earthy sub- 
stances. The best instance of this water is that of the Furnas, 
St. Michael's, Azores. The Vichy waters are alkaline, and are 
often added to acid wines, which they neutralize. They are useful 
where there are deposits of uric acjd in the urine; and from the 
small yet efficient proportion of iron they contain, they increase 
the appetite and strengthen the digestive powers. 

The water is as nearly tasteless as possible, perfectly clear, 
and without smell. Ems, Teplitz, Mont d'Or, and Ischia are of 
this kind. The waters of Ems and Teplitz are warm. The only 
mineral waters in England, which contain carbonate of soda, are 
Malvern, in Worcestershire, and of Ilkeston, in Derbyshire. 

These waters are useful in gout, indigestion, and the lithic acid 
tendency. 

Acidulous Waters^ or carbonated, are brisk and sparkling. 
They slightly redden litmus paper if the waters have not been 
boiled; the redness disappears on exposure to the air. Besides 
free carbonic acid, they contain bicarbonates of soda, lime, mag- 
nesia, and sometimes of iron. There are either warm or cold 
acidulous waters. 

Of this kind are the springs of Cleves, Carlsbad, Kissingen, 
Fachingen, Marienbad, Greilnau, Rippoldsau, Soden, and Tonstein, 
in Germany; Languac, Upper Loire; Passy, near Paris; Wies- 



122 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

baden, in Nassau; Bandola, in Italy; Granshaw, in Ireland; but 
Pjrmont, Seltzer, Spa, and Carlsbad are the most celebrated. 

All these waters afford a grateful and moderate stimulus to 
the stomach. The Pjrmont and Spa, from containing some car- 
bonate of iron, are most useful in all cases of impaired* digestion; 
while the Altwasser, Salzbrunn, Reinerz, Carlsbad, and Seltzer, 
which are more purely alkaline, are useful in gravel and calcu- 
lous affections. 

The Chalyleate or Ferruginous Waters owe their properties to 
iron. Thej have an inky, styptic taste. When newly drawn 
they are transparent, and strike a black color with tincture of 
nutgalls or with tea. The iron is often combined with excess 
of carbonic acid ; but it may consist of the sulphate of iron. The 
acidulated chalybeate waters of the Pyrmont TrinkqueUe, or 
Drinkspring, of the Swalbach and Spa, are brisk, pleasant,, and 
grateful. 

Chalybeate springs are numerous in the United States. The 
most noted of these are Ballston and Albany, in the State of 
New York ; Hopkenton, in Massachusetts ; Bedford, Pittsburg, 
and Frankford, in Pennsylvania. Virginia, Kentucky, Tennessee, 
and Ohio all boast of waters of the same class. The Bedford 
springs are the most celebrated in Pennsylvania, and justly stand 
among the foremost. As a chalybeate, the Bedford is about the 
same with Ballston and Saratoga waters. It has less common 
salt than these, but has a decided impregnation, says Bell, of 
Epsom salts, by which it is better fitted to act on the stomach and 
bowels. The accommodations at these springs are good, and the 
surrounding country delightfully pleasant and healthy. 

Chalybeate springs are very numerous. On the continent of 
Europe are the following: Abcourt, St. Germain; Aumale and 
Fourges, near Rouen ; Bologna ; Buzot, a warm spring in Spain ; 
Caroline Baths, in Bohemia; Daswild, Baden, in Germany; Dri- 
burgen, in "Westphalia ; Naptha, in Russia ; Nisdenice, in Germa- 
ny ; Schwalbach, in Nassau ; Ponges, Hassenfratz ; Perekop and 
Sarepta, in Russia; ScoUiensis, Switzerland; Suchalda, Hungary; 
and Yechy, near Moulines. In Great Britain there are those of 
Arbroath and Peterhead, in Scotland ; Ashton, in Wiltshire ; Bale- 
mere, Worcestershire ; Ballycastle, Antrim; Ballynahinch, Down; 
Ballyspellen, Kilkenny; Bandon, Cork; Bromley, Kent; Browns- 
town, Kilkenny; Castleconner, Kilkenny; Castleconnor, Limerick; 



MINERAL WATERS. • 123 

Castlemaine, Coalcullen; Corville, Coventry ; Croptown ; Doner- 
aile ; Dunnard, near Dublin; Galway; Garryhill, in Ireland; of 
Haigh, in Lancashire ; Hampstead, Hartfell, Scotland ; Islington ; 
Kilcoran, Kilagre, Kirby, in Westmoreland; Lancaster; Llandri- 
dad, Wales; Luz, in Essex; Listerlin, Mallory, Newton Stewart; 
Oakfield, Phoenix Park, Dublin; Scool, in Ireland; of Shadwell, 
near London; Somersham, Hants. Tunbridge, Brighton, and 
Peterhead are the most celebrated. 

The Cheltenham contains carbonate of iron. 

When preparations of iron are taken into the stomach, they 
are partly absorbed, partly evacuated, more or less changed with 
the stools. The red color which the sesquioxide of iron commu- 
nicates to the stools of children, and the black color of the stools 
after the employment of the salts of iron, are proofs of the pres- 
ence of iron in the motions. And iron has been detected in the 
blood, urine, and milk. 

When the preparations of iron have been given in cases proper 
for its employment, the appetite increases, digestion is promoted, 
the pulse becomes fuller and stronger ; the skin, from being too 
pale or sallow, assumes its natural tint ; the lips and cheeks be- 
come florid, the temperature of the body is raised, all swelling 
of ankles, etc., disappears, and the strength is increased. Con- 
sequently, where there is a full habit of body, flushed face, full, 
quick pulse, etc., chalybeates would be decidedly injurious. The 
iron acts upon and alters the constitution of the blood, as chem- 
ical analysis has shown, but which analysis need not here be 
detailed; consequently, chalybeates are fitted for cases of indi- 
gestion, scrofulous disorders, cancer, stoppage of the periods when 
connected with debility ; non-appearance of them — green sickness. 
Much of the efficacy depends on the extremely minute division 
of the iron, and the other components, while their operation is mod- 
ified by the carbonic acid in w^hich the iron is suspended, and they 
usually agree better with the stomach. When these waters sparkle 
in the glass, they should be drank the moment they are drawn 
from the spring. With those not carbonated this does not matter. 

The Aluminous Chalybeates. — Those which contain sulphate of 
alumina — namely, the sand-rock in the Isle of Wight, the strong 
Mofi'at chalybeate, the Vicar's Bridge chalybeate, .and the Passy 
waters — are apt to occasion pains in the stomach if taken in an 
undiluted state. 



124 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

The Sulphureous or Hepatic Waters are impregnated with hydro- 
sulphuric acid (sulphureted hydrogen); and by virtue of this 
sulphur-eted hydrogen, they have the smell of rotten eggs; and 
when solutions of lead, silver, copper, bismuth, etc., are added 
to these waters, black precipitates fall, which are metallic sulphur- 
ets. When strongly impregnated with the gas, they will redden 
litmus paper, and blacken silver and lead when even in a weak 
state. But some of these waters retain, even after boihng, their 
power of causing these precipitates. And then there is a sul- 
phuret or hydro-sulphuret of calcium or sodium in solution. All 
the British sulphureous waters are cold; but some of the conti^ 
nental are thermal or warm. 

These waters exercise a stimulant influence over the system, 
and are adapted for chronic ailments. They are supposed to 
exert a specific power over the skin and the womb. They are 
employed both internally and externally in skin diseases, lepra, 
psoriasis (scaly tetter), itch, dandruff, ringworm, etc. ; in non-ap- 
pearance, or stoppage of the periods ; in chronic rheumatism and 
gout, in piles, and in some cases of bronchitis. They certainly 
act on the skin, and are sudorific (sweat-inducing) and diuretic. 
They are given in obstructions, or torpor of the liver or bowels; 
in scrofula, and in some hypochondriac or dyspeptic cases. They 
are apt to occasion headache, which lasts a short time, directly 
after they are drank. 

Saline Waters owe their properties to saline compounds, con- 
sisting of salts, the basis of which is lime, or chlorides of sodium 
and magnesium, or sulphate of magnesia (Epsom salts), or alka- 
line carbonates — carbonate of soda, especially. Most of them 
are purgative, the great proportion of water adding to their 
effect. 

The most celebrated springs are those of Cheltenham, Leaming- 
ton, Bristol, Kinalton; Pancras, near London; Scarborough, Sy- 
denham, and Thursk, in Yorkshire ; Pitcaithly, in Scotland ; and 
on the continent of Europe, Carlsbad, Pullna, Seidschiitz, and 
Seidlitz. 

Their use is required wherever an aperient action on the bowels 
is demanded, as in indigestion, hypochondriacism, chronic disease 
of the liver, jaundice, and the various forms of scrofula. Some 
contain a good deal of carbonic acid, and are more grateful, 
others contain some iron, as in the Cheltenham waters — which 



MINERAL WATERS. 125 

last are serviceable in stomach ailments and stoppage of the 
periods. They may be divided into bitter purging waters, in 
which Epsom salts predominate, as those of Epsom and Scar- 
borough, in England; Seidlitz, Seidschiitz, and Pullna, and a 
thermal water, Acqua del Pozzato, near Pisa. 

Glauber Salts Waters, as the warm Carlsbad, which are also 
alkaline as well as purgative, and the cold waters of Marienbad 
(the Kriizbrunnen and Ferdinansbrunnen), and Franzensbrunn 
(the Salzquelle), Cheltenham, Leamington, and Spittai, are earthy 
Glauber salt waters, useful in diseased liver, dropsy, piles, blood 
to the head. Salt or brine waters contain iodine and bromine, 
with chloride of sodium (common salt). Those of Middle wich, 
Nantwich, in Cheshire; Shirleywich, in Staffordshire; and Droit- 
wich, in Worcestershire, are of this kind. The Kreuznach and 
Salzhausen Springs, in Germany, belong to this class; also the 
thermal waters of Wiesbaden, Baden Baden, and Bourbonne. 
The common salt springs are the Cheltenham old well, Leam- 
ington, and Pyrmont. Some contain iron, as those of Kissingen 
and Hamburg. 

The bromine and iodine salt springs are the Woodhall or iodine 
spa in Lincolnshire, and the Kreuznach. The waters of the Dead 
Sea are of this kind. They are useful in glandular enlarge- 
ments — scrofula. 

Alkaline Waters. — The acidulated alkaline have been noticed. 
The Vichy, for instance. The Seltzers contain common salt; 
the Carlsbad contain Glauber's salt. Some contain iron, and 
have been noticed. Those containing carbonate of soda are Mal- 
vern, in Worcestershire, and Ilkeston, in Derbyshire, England — 
useful in gout, indigestion, and gravel, of the red or uric acid 
kind. 

To the class of Saline Mineral Waters, the water of the ocean 
belongs. The saline matter contained varies in different latitudes. 
Between 10° and 20°, it is rather more than one twenty-fourth; 
at the equator, one twenty-fifth; and at 57° north, it is one 
twenty-seventh. Brought up from a great depth, its taste is 
purely saline; when from the surface, it is disagreeably bitter, 
owing probably to the animal and vegetable matters suspended 
in it. Its specific gravity varies from 1.0269 to 1.0285, and it 
does not freeze till cooled down to 28.5° of Fahrenheit. Its 
properties as a medicine resemble those of the saline purging 



126 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

waters, but they are more powerful as a bath. Its efficacy is 
much superior to that of fresh water. 

The diseases which are likely to be benefited by the use of 
mineral waters will now be mentioned, and those waters which 
are adapted for special disorders. They would seem to act ben- 
eficially, in the first instance, on the digestive organs; and, as 
many diseases of the skin and other parts are connected with or 
depend upon those organs of nutrition, we see how the benefit 
may arise from putting them into a healthy state. 

Disorders of the Digestive Organs. — Traveling and the mere 
change of climate ijiay suffice to relieve or cure many of th-e lighter 
cases, but in the more chronic instances more is wanted. In 
such cases, mineral waters increase and correct the action of the 
secreting and excreting parts of our frame-; the blood is thus 
cleared of its vitiating ingredients, and any congestion or fullness 
of particular organs is removed. 

In indigestion of long standing, when there is no dry, red 
tongue, no thirst nor other signs of excitement or irritation, 
mineral waters, well chosen, will do good; but in inflammatory 
indigestion they will do harm by the excitement they occasion. 

When we have reason to believe that the mucous membrane 
of the stomach and bowels is in an irritable or congested state, 
complicated with chronic liver disease, or when the usual periods 
are not regular in their appearance, the waters of Ems, Yichy, 
or of Plombieres will be useful, especially if the system is not 
too relaxed. 

If this state of bad digestion be mixed up with chronic afi"ec- 
tions of the air passages, or with diseases of the skin, then the 
waters of Cauterets, in the Pyrenees, will be the best adapted. 

Should the liver and stomach be in a torpid state, as shown 
by the usual signs, Marienbad, Carlsbad, and Kissingen should 
be chosen for residence. The cold aperient waters of Marien- 
bad will answer well if active aperients are not required, but if 
they are, Kissingen waters will suit better, fi'om being more ex- 
citing. 

In atony of the stomach, with nervous debility of the system, 
and in debility of the womb and its functions, the invalid may 
begin with a course of Ems, Carlsbad, or Kissingen waters, and 
then go to Pyrmont or Schwalbach. To keep up some action 
on the bowels, the Eger waters are sufficient, but when a more 



MINERAL WATERS. 127 

tonic effect is sought, the waters of Schwalbacli or Pyrmont are 
preferable. 

But none of them will do good if there is organic disease in 
the stomach or a state of irritation. 

The waters may, at the same time, be used externally as baths. 
All excitement is to be avoided while taking these waters. 

The thermal saline waters, called the warm springs of North 
Carolina, deserve a notice. Paralysis and chronic rheumatism 
are among the diseases cured by drinking these waters. Of the 
cold saline springs of the United States, those of Saratoga are 
the most celebrated. They contain a large amount of carbonic 
acid; they, too, contain carbon to so great an amount that they 
might be called, with propriety, chalybeate ; but as they have 
a free action on the bowels, we place them under the head of 
saline waters. From one to three pints of what is called con- 
gress water, when taken before breakfast, will generally open the 
bowels freely. Dr. Steel's valuable work on the Saratoga waters 
should be consulted by those wishing to visit watering places. 

Of the various hot springs which abound in the United States, 
those of Virginia stand among the foremost; but probably the 
hot springs found on the upper waters of the Washita, in north 
latitude 34° 31', near the base of the south-eastern slope of the 
Ozark Mountains, are the best. These celebrated springs lie 
about six miles north of the Washita River. (See Major Long's 
expedition to the Rocky Mountains.) They are situated in a 
region elevated from seven to fourteen hundred feet above the 
level of the sea, and in an undulating, poor, and stony country, 
where health may be restored if pure air can effect such result. 
Here the springs are about seventy in number, and burst out 
near each other, some of them falling from the cliffs eight or ten 
feet, giving the finest opportunities for many kinds of bathing. 
The water ranges in temperature from 92° to 151° Fahrenheit, and 
is almost pure, holding a little saline in solution. We have seen 
a number of patients who had been much benefited by bathing, 
etc., in these waters; the rough country and plain living having, 
no doubt, added much to the relief obtained. Chronic rheuma- 
tism is the disease which they mostly benefit. The time is not 
far distant when these springs will be greatly resorted to — as 
much, probably, as any in the country. 

Bronchial Diseases. — Ems, Bonnes, and Cauterets, and Mont 



128 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

d'Or, in Auvergne, are the places recommended in these affec- 
tions. In bronchial invalids of delicate constitutions, the waters 
of Ems; in those demanding mountain air, or complicated with 
skin disease, those of Bonnes or Cauterets ; and in languid, de- 
fective action of the -skin, with chronic bronchial suffering, the 
waters of Mont d'Or; but when the air passages are suffering 
secondarily, after congestion of. the liver and abdomen, the waters 
of Carlsbad, Marienbad, or Kissingen are pointed out as most 
suitable. 

Asthma. — A difficulty exists in recommending any mineral 
water for pure asthma, because some asthmatics can not live 
high up on mountainous land; and others can not breathe in 
lowland valleys; but where bronchial irritation or disorders of 
digestion are added to asthma, then mineral waters may prove 
beneficial. If asthma is complicated with heart disease, mineral 
waters are altogether inadmissible, and will prove decidedly in- 
jurious. 

Gout. — For chronic gout. Ems, Carlsbad, Marienbad, Aix-la- 
Chapelle, and Wiesbaden waters may be taken. The soothing 
effects of the Ems waters form a good preparation, in many 
cases, for the more opening and purifying waters of Carlsbad, 
and then may advantageously be followed by bathing and the 
douche at Wiesbaden or Aix-la-Chapelle ; and they are very 
beneficial when the joints have been rendered stiff and swollen 
from repeated attacks. Friction and the douche often effect 
much benefit in this last case. Any disposition to heart disease, 
or to disease of the brain, contra-indicates and forbids the use of 
any mineral waters. 

Rheumatism. — Climate and mineral waters are very beneficial 
in chronic rheumatism. Those of Aix, in Savoy; of Cauterets 
and of Bagneres-de-Luchon, in the Pyrenees, and of Aix-la- 
Chapelle, are all highly recommended; and the two latter when 
there is a complication of skin disease. But if the stomach or 
liver is disordered, or the mucous membrane irritable, these 
organs must be first looked to, and the waters best adapted for 
them must be made use of. They have been pointed out. 

The preceding summary of directions, so far as they relate to 
European waters, has been taken from Sir James Clark's rec- 
ommendations, but our notice of the American waters is de- 
rived from other reliable sources. 



MINERAL WATERS. 129 

The number of glasses of each water, the hours for taking 
them, the walks necessary before and after, the mode and times 
in which the bathing should take place, and the adaptation of 
quantity or of different springs to individual cases, had better be 
left to the direction of the attendants at the respective places. 

One of the most celebrated watering places in the Mississippi 
Valley is tha.t called the Blue Licks, in the valley of the Licking 
River, in Kentucky. From the water of these springs, common 
salt was formerly made; but the water is too weak to now allow 
of the profitable manufacture of this article for commercial pur- 
poses. 

These saline waters contain a considerable amount of sulphur- 
eted hydrogen, which gives them a disagreeable taste afiid smell; 
when taken on an empty stomach, in the quantity of half a pint 
or more, they act as a laxative, and have often, on persons of 
constipated habits, a favorable influence. These waters are car- 
ried in barrels over much of the Valley of the Mississippi, and 
in many places extensively drank; and in many cases with ad- 
vantage, particularly if taken on rising in the morning. 

It is proper here to say that the German Kissengen water is 
manufactured at New York and at Cincinnati, and is equal if 
not superior to the original, as it is said to contain more car- 
bonic acid gas. These manufactories were first established at 
Cincinnati by Dr. S. Handbury Smith, now of New York. We 
are happy to learn that this scientific gentleman has succeeded 
to his m'ost sanguine expectations. He now sends this water 
over much of the civilized world. He also manufactures imita- 
tions of various other European waters. 

9 



130 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



CHAPTER IV. 

ON DISEASES. 

Disease produces fatal results chiefly in three ways : by fever^ 
by inflanyaiation or its results, or by morbid — that is, diseased — 
deposits, such as cancer, scrofula, etc. And of modes of treat- 
ment there are also three. Either we find ourselves obliged to 
adopt a lowering mode of treatment, as in some fevers and 
almost all inflammations, or we must try to give support to the 
powers of life by a treatment the reverse of lowering ; or we must 
be neither too active in lowering nor in supporting, but adopt a 
waiting, watching method of treatment. 

Fever. 

As fevers and inflammations are the most energetic and fatal 
enemies to life, we begin with the consideration of fevers. 

Fever derives its name from one of its most prominent symp- 
toms; namely, a sense of increased heat; and the reader should 
make himself well acquainted with its signs. Fever attends sev- 
eral diseases, as will be seen hereafter; but at present we mean 
to point attention to what may be called primary fevers, those 
which are not combined either with eruptions of the skin or with 
inflammation of any particular part of the body. Such fevers 
may be divided into six difi'erent kinds: 

1st. Continued fever, which may be subdivided into inflamma- 
tory fever, mixed fever, typhus.. 

2d. Intermittent fevers, subdivided into tertian, quotidian, 
quartan. 

3d. Remittent fevers. 

4th. Infantile gastric fever, yellow fever. 

5th. Eruptive fevers, such as small-pox, measles, scarlet fever, 

6th. Hectic fevers. 



INFLAMMATORY FEVER. 131 

The terms continued, remittent and intermittent, will be ex- 
plained as we describe each kind. 

The symptoms of continued fever were thus described by Cullen : 
It is a disease in which, after a precursory stage of languor, de- 
fective appetite, and muscular weakness, the pulse becomes accel- 
erated, the heat of the body increased ; there is great debility of 
the limbs, and a disturbance of most of the functions, yet there 
is no primary local disorder, nor are there well-marked remis- 
sions. The word remission means great diminution, or a tem- 
porary cessation of the febrile symptoms. 

The symptoms vary in intensity, and in the periods of their 
accession, and local inflammations may supervene on the gen- 
erally febrile state. 

Inflammatory Fever, technically Synocha, 

is not often met with. It is defined thus : After a stage of chilli- 
ness or shivering, the heat of the body is greatly increased, the 
pulse is hard, to the finger and frequent ; red deposit in the urine ; 
the mental faculties are but little disturbed, and sweating usually 
terminates the attack. 

The initiatory signs are, feebleness, languor, and a sense of 
oppression, loss of appetite, sickness or vomiting, frequent and 
feeble pulse, to which succeed pain in the back, chilliness or 
shivering, paleness of the face, and puckered or goose skin. 
Then, after a few hours, the pulse becomes hard and rapid, the 
pulsations amounting to 120 or even 150 ; the skin is parched and 
very hot, its temperature rising to 102°, and even to 106°; the head 
aches greatly, the temples throb, there is giddiness; the face is 
flushed, the tongue is white and dry ; great thirst, constipation ; 
the urine is scanty and red, and there is often a frequent desire 
to pass it; while the sight and hearing are extremely acute. 

Delirium may come on after a few days, and all the symptoms 
are increased in intensity in the evening, and diminished in the 
forenoon. 

This form of fever may terminate after some critical discharge, 
or it may gradually disappear, or it may assume a typhoid form. 
The amehoration may occur on or before the seventh day; but if 
it continue much longer than seven days, the inflammatory signs 
disappear, and gradually change into those of a typhoid character. 



132 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

If a tolerably profuse sweating occur on the fourth or fifth day, 
the patient is soon relieved from his febrile state, although he may 
be left in a weak, languid condition. 

Convalescence is slow, and relapses are not uncommon. 

Causes. — A full habit of body, a strong muscular power, and 
what is called a good constitution predispose to the disease; while 
the exciting causes are sudden alternations of temperature, cold 
applied to the heated body, too violent exercise, intemperance, 
suppression of any accustomed discharges or cutaneous eruptions. 

Favorable symptoms are perspiration, bleeding from the nose, 
eruptions appearing about the lips, a gentle looseness of bowels, 
the urine depositing a sediment like brickdust, the pulse becom- 
ing softer and more slow. The unfavorable signs are increase of 
intensity in the symptoms, fierce delirium, and laborious respiration. 

Treatme7it. — -The excessive action must be lowered by bleeding, 
purging, and by diaphoretic or sweat-inducing medicines. 

If there is no medical man at hand to bleed, ten or twelve 
leeches may be applied to the temples, and, if necessary, re- 
peated ; but it is best to take blood from the arm, if that can be 
done, and the quantity of blood to be taken must be regulated by 
the efiects produced, of which a medical man is the best judge. 

A pill thus composed should be given, unless the bowels are 
very freely open: 

No. 1. Of Blue pill 2 grs. 

Calomel 1 gr. 

Compowid extract of colocynth 2 grs. Mix. 

Or, if the bowels require more active treatment, take 

No. 2. Blue pill 2 grs. 

Calomel 5 grs. 

Compound extract of colocynth 5 to 10 grs. 

This should be followed in some four hours by this mixture: 

No. 3. Epsom salts ., 1 oz. 

Compound infusion of senna (see Formulae) 5J oz. 
Syrup of orange-peel i" oz. 

A third part to be taken every four hours until the bowels are 
freely opened. Or, 

No. 4. Epsom salts 1 oz. 

Fluid extract of senna 2 oz. 

Syrup of orange-peel 4 oz. 

To be taken as No. 3. 



INFLAMMATORY FEVER. 133 

There is no better purge in this fever than 

No. 5. Calomel 5 grs. 

Jalap , 20 grs. 

Cream of tartar 40 grs. 

Taken in water. 

Saline or fever draughts should be^iven every four hours. 

No. 6. Bicarbonate of potash. r. . 24 grs. ' 

Lemon -juice should be added until the bubbles of 
effervescence cease to rise. 

Distilled water 1 oz. 

Syrup 1 dr. 

If vomiting occur, give draughts in a state of effervescence 

every four hours. 

No. 7. -Of Bicarbonate of potash 30 grs. 

Syrup 1 dr. 

Water 1 oz. 

Then mix in another glass, tartaric acid 25 grs. in water. 1 oz. 

Pour the one into the other, and drink immediately. One 
drop of the medicinal hydrocyanic acid may be added to each 
draught if it can be got. The medicinal, not the strong acid. 

Cold applications must be made to the head and temples, so 
long as they are grateful to the patient, and the body may be 
sponged with cold water, until the heat of the skin is lowered, 
or perspiration promises to ensue. 

For drink, either of the two following : 

No. 8. Cream of tartar |- oz. 

Sugar ^. . about J lb. 

Dried lemon-peel from J- to J- oz. 

Boiling water 4 pints. 

Or this ; 

Of syrup of lemons 3 oz. 

Distilled or soft water 2 pints. 

-Nothing should be allowed in the shape of food. 

If the disease does not give way after the first week, it may 
lapse into the next form — mixed fever. 

When the feverish symptoms have left, we must be cautious 
to prevent a relapse, and especial attention must be paid to diet, 
allowing, first, arrowroot mucilage or arrowroot and milk, thin 
weak broth or beaf tea with rice, increasing all nutritious mat- 
ter very gradually, proceeding to white-fish, mutton, etc., until 
the usual diet can be borne without any bad effects. 

If very weak, a tonic infusion will be of benefit. 



134 AMERICAN HOUSEHOLD BOOK OP MEDICINE, 

1st. Tonic Infusion. — Infusion of Calumba. 

No. 9. Of calumba root, cut small |- oz. 

Boiling water 1 pint. 

Let this liquid stand in a gentle heat for two or three hours 
in a covered vessel; when cold, strain. 

An ounce or a wine-gla|pful of this, two or three times daily, 
may be taken. If the spirits are much depressed, add twenty or 
thirty drops of sal volatile to each dose, and if there be acidity 
after eating, add also twenty grains of the bicarbonate of potash 
to each dose. 

2d. Tonic Infusion. — Comj)onnd Infusion of Orange-peel. 

No. 10. Of dried orange-peel \ oz. 

Recent lemon-peel J oz. 

Cloves, bruised 1 dr., or 60 gr. 

Boiling water 1 pint. 

Let these be set by in a gentle heat, covered over, for about 
half an hour ; when cold, strain. The sal volatile or potash may 
be added to this if requisite. 

3d. Tonic Infusion. — Compound Infusion of Gentian. 

No. 11. Of gentian root, cut small 2 dr. 

Dried orange-peel 2 dr. 

Becent lemon-peel 4 dr. 

Boiling water 1 pint. 

Let it stand for an hour, in a gentle heat; when cold^ strain. 

The dose of the above infusions is from two to four table- 
spoonfuls. 

The best tonics are made of Peruvian barks and some of the 
mineral acids, as, • 

No. 12. Pulverized bark 1 oz. 

Infused for one hour in one pint of water. 

Add sulphuric acid 1 dr. 

Strain. 

Give two table-spoonfuls three or four times a day; or, if the 
patient be very weak, one grain of quinine may be given every 
four hours. 

It must not be forgotten that the inflammatory fever often lasts 
many days, and that one purge during this time is not enough. 
The bowels should be moved two or three times during the 
twenty-four hours. For this purpose there is nothing better than 
from 20 to 60 grains of the compound powder of Jalap and 
cream of tartar. Take in water when, necessary. 



MIXED FEVER. • 135 

Mixed Fever, technically Synochus. 

This is the kind of fever which prevails most generally, and 
the reason for denominating it mixed fever is to be found in the 
fact that it may begin with signs of considerable excitement, 
which, after a time, glide into those of a* typhoid character. It 
may be said to be a compound of synocha and typhus. 

We observe in most cases the usual preliminary symptoms — 
paleness of face, languor, loss of appetite, whiteness of tongue, 
alvine motions changed in character, perhaps wandering pains. 
Sometimes this fever sets in suddenly with a shivering fit, and 
headache more or less severe. Then the pulse becomes fre- 
quent, most so in irritable constitutions, pulsations varying from 
100 to 120, and in severe cases to 140. The skin is hot and 
dry, the thirst troublesome ; the tongue becomes dry, and is most 
frequently furred, though it may be for a few days clean and 
smooth; it is red about the tip and edges, with a streak, more 
or less broad, of fur in the middle. This streak is of a light 
brown color, which soon deepens. 

This state may continue for six or seven days, when typhus 
supervenes if the fever has not yielded. 

Causes. — Cold and moisture in a debilitated habit of body, and, 
beside these, contagion, which last we shall revert to under the 
head of typhus. 

Treatment. — In mixed fever we must never forget that typhus 
is to be dreaded; wherefore we must content ourselves with reme- 
dies which will not materially impair the strength or lower power.. 

Few medical practitioners of the present day think that a fever 
can be cut short, as it is called, by any remedies known; but some 
have recommended an emetic for this purpose, and certainly if 
there have previously existed signs of a> foul or loaded stomach, 
an emetic might be of service; if there is not much determina- 
tion of blood to the head, as evidenced by beating of the arteries 
at the temples, violent headache, redness of face, injected eyes.. 
Under these latter circumstances, an emetic should not be given. 

To an adult give the following: 

No. 13. Of powdered ipecacuanha 20 gr. 

Tartar emetic ► 1 gr. 

In an ounce or two of water. • 

After it begins to operate, some diluent drink may be taken. 



136 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

whicli ^ill assist its action ; but large quantities of fluid, taken 
into the stomach before the emetic has begun to act, will not 
only do mischief by distending the stomach, but they may pre- 
vent the action of the medicines altogether. 

Gentle aperients (purgatives) should next be given, if the bowels 
have been in a costive state, before the invasion of the fever. 

No. 14. Of Epsom salts 1 oz. 

Compound infusion of senna 6 oz. 

Compound tincture of cardamoms.. .3iv.=|- oz. 

A fourth part every four hours till it operate. But an aperient 

(purgative) may be given with each saline draught till proper 

action of the bowels has ensued, when the saline draughts should 

be continued. 

No. 15. Of Bicarbonate of potash 24 gr. 

Tartaric acid 20 gr. 

Tartrate of potash . , 2 dr. 

Distilled water 1 oz. 

Simple syrup, or syrup of orange-peel ... 1 dr. 

Dissolve the bicarbonate in the w^ater, add the tartaric acid, and 
when effervescence has ceased, add the tartrate and syrup. 

As soon as the bowels have acted sufficiently, withdraw the 
tartrate of potash, and continue the remainder. 

For the headache, apply evaporating lotions to the forehead, 
and if it be violent, six to ten leeches, according to the apparent 
strength of the patient, may be applied, though they are better 
avoided, when the streak on the tongue covers a considerable ex- 
tent of it, and assumes more and more a dark brown color; for 
then typhus probably impends. 

The headache is, however, sometimes so violent as to force us 
to resort to leeches. If so, apply them in parts where efficient 
pressure can be made on the leech-bites, should they bleed too 
profusely. Leeches will be again alluded to, and directions given 
how to manage them. 

An evaporating lotion will prove grateful and soothing to the 

feelings. 

Cooling and Evaporating Lotion. 

No. 16. Of rectified spirit of wine 1 oz. 

Water 7 oz. 

Apply cloths wetted with this to the forehead, temples, etc., 
and renew them as they become hot. For the spirit of wine, Eau 
de Cologne may be substituted. 



MIXED FEVER. 137 

Some medical practitioners have recommended our throwing 
repeated buckets of cold water over the patient, and consider this 
affusion a great agent in cutting short the fever at its commence- 
ment ; but the author has never seen it effect this, for he believes, 
with many others, that we can guide a, fever, though we can not 
cure it. He has seen great benefit derived from this affusion 
when the heat has been much and steadily above the natural 
standard ; and in some cases, of eight or nine days' continuance, 
he has believed it had caused a critical change toward recovery. 

The surface of the body may be sponged with cold water, so 
long as it remains hot and dry. 

The drinks may be barley-water, toast-water, etc. (See Man- 
agement OF THE Sick Room.) 

Sometimes this fever is complicated with an inflammatory state 
of brain, chest, or abdomen; but such states will be mentioned 
in the portion deyoted to typhus. ^ 

If the signs of high action ; namely, a very hot skin, flushed 
face, injected eyes, and throbbing at the temples, seem to yield 
rapidly, or to change into those of nervous depression — to be 
shortly described — then for the saline draughts just recommended 
should be substituted any one of the tonic infusions, the com- 
pound infusion of gentian, of orange-peel, or of calumba. 

To one ounce of each, or either of these, thirty grains of 
bicarbonate of potash or of soda may be added; and if much 
languor and depression prevail, twenty to thirty drops of sal 
volatile may be added, or these ammonia draughts taken instead 
of them : • 

No. 17. Of sesquicarbonate or bicarbonate of 

ammonia 9iv. = 80 gr. 

Lemon juice 3 oz. 

Or citric acid 96 gr. 

Or tartaric acid 100 gr. 

Water ^ vss. = 5 J oz. 

Syrup ^ oz. 

A fourth part for a dose three or four times in the twenty-four hours. 

If the draughts are desired to be taken while effervescing, dis- 
solve twenty-four grains of the citric acid, or twenty -five grains 
of the tartaric acid in water, and add to it a fourth part of the 
mixture of ammonia, water, and syrup. 

Of the lemon-juice, six drachms, or three-fourths of a fluid 
ounce, would be required to neutralize the ammonia contained in 



138 AMERICAN HOUSEHOLD BOOK OF MEDICINE. ' 

a fourtli part of the mixture. This is a very pleasant and grate- 
ful medicine, whether taken during effervescence or not. 

In fevers of this character, one or two grains of calomel should 
be given every night ; and the following has been found of much 
use: 

No. 18. Opium .- . . 2 grs. 

Calomel . 4 grs. 

Ipecac 4 grs. 

Mix and make eight powders. Give one every four hours. 
These powders quiet the irritation, and often procure sleep. Six- 
teen doses may be given if the fever persists. 

Typhus Fever. 
Putrid, or Spotted, or Maculated Fever, 
is divided into the mild and severe species, differing only in the 
intensity of the symptoms. 

This fever is a desolating scourge, and carries off many vic- 
tims during the year. 

Symptoms. — As the inflammatory fever may pass into the form 
of mixed fever, so this latter merges into typhus. 

Typhus is characterized by a compressible, somewhat frequent 
pulse, with no great increase of the animal heat, extreme de- 
bility, and more or less disturbance of the mental functions 

General languor and lassitude; the tongue shows from the 
commencement a brownish streak down its middle, while its other 
portions may be of a dusky red; there is loss of appetite; thirst; 
drowsiness; sleep disturbed by dreams or slight wandering; the 
eyes lose their usual bright appearance, and present a suffused, 
muddy aspect; the bowels may be loose; the urine scanty, high- 
colored, with a bad smell ; immoderate sweating, in some cases, 
which are succeeded by dehrium ; coma (a state of unnatural sleep) ; 
the stools are passed involuntarily; the extremities become cold; 
the hands seem to pick the bed-clothes ; hiccup ; there are startings 
of the legs and wrists ; convulsions ; and death closes the scene. 

The symptoms during the first seven or eight days are those 
usual in fever, with disturbance of the nervous functions, and 
muscular disability or weakness superadded. 

After this time, if not before, the teeth are incrusted with a 
dirty-looking deposit, very characteristic; the pulse becomes 
weaker and weaker, feeling to the finger as if a small column 



TYPHUS FEVER. 139 

of water fluctuated under it ; tlie tongue is drier and browner ; 
the headache leaves the patient, but the delirium, hitherto only 
observable at night, or after sleep, shows itself during the day; 
the voice is feeble; the power of swallowing difficult, perhaps 
lost; and the patient lies on his back, not having strength to 
turn on his side. The patient lies thus rambling and muttering 
continually, and though 'he may be roused for a time, yet he 
relapses. About this time, too, a rash appears of small blotches, 
roundish, and scarcely raised above the surface of the skin; 
with these, purple spots, like flea-bites, appear; but they are 
distinguished from flea-bites by the absence of the mark of the 
central puncture made by the flea. These spots vary in s?ze 
from that of a pin head to that of a dollar. If there is copious 
sweating, an eruption may, in some few cases, be observed of 
small elevations of the cuticle, which, when viewed sideways, 
look like drops of water on the skin. * These usually dry up, 
the cuticle is wrinkled, and a whitish powder remains. 

During this stage, the second as it may be called, an inflam- 
matory state of either head, chest, or abdomen may occur, and 
seriously add to the danger. These are called the consecutive 
or secondary afiections in continued fever. 

When the head is thus attacked, there are dingy redness of 
the countenance, heat of head; the sufl"usion of the whites of 
the eyes is greater than usual, and the stupor and delirious mut- 
terings are more observable. 

When the chest is attacked, there is a sort of suppressed dry 
cough, and the breathing is more impeded than usual. The 
stethoscope at once reveals to us the existing state. There may 
co-exist an ulcerated throat. 

The abdominal attack is characterized by tenderness or pain 
at the pit of the stomach, and if the bowels are also suffering, 
there will be pain on pressure, with a dischaijge from the bowels 
of yellow, ochre-looking stools, and the belly is distended like a 
drum. The liver may be implicated, and jaundice present. 

About the end of the. second week the symptoms may become 
milder, and a favorable change may -noAV take place, leading to 
recovery ; if not, during the third stage, the patient lies at last 
almost like a log of wood, discharges of blood from the bowels 
occur, and the worn-out patient dies. 

Relapses are frequent, and may easily be brought on by want 



140 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

of care to avoid cold, improper diet, or any of the causes of 
fever. The constitution may be left in a weak state, the legs or 
ankles swelled, and other diseases may follow as sequels to this 
terrible fever. 

Causes. — Those who are weak in body, and susceptible or irri- 
table in mind, are disposed to suffer. All over-exertion of mind 
or body, the depressing passions, poor living, intemperance, dissi- 
pation, cold, wet, filth, and filthy exhalations from putrefying or 
decomposing animal and other matters — these last are the most 
fruitful sources of typhus — and persons have been seized soon 
after exposure to the miasms or vapors from cesspools, sewers, 
etc. The immediate or exciting cause is contagion. 

Treatment. — The treatment of the first stage is that already 
described in mixed fever, only that the tonic infusions must be 
taken at a very early period. 

The strength must be husbanded in every way, to enable the 
patient to go through the latter exhausting stages. 

Cold douche of the head, evaporating lotion, ice to the head; 
affusion of cold water may be tried in the first day or two, cold 
sponging as long as it may be agreeable to the sufferer. The 
bowels should be opened by a pill, consisting 

No. 19. Of Blue piH 2 grs. 

Compound extract of colocynth 3 grs. 

Then a Seidlitz powder, if the pill does not operate effectually. 
After these, purgatives need scarcely be repeated, but lavements 
or clysters of warm water may be occasionally thrown up to clear 
the lower bowel. 

So long as the stage of excitement lasts, so long as great heat 
of skin, a tolerably strong pulse, beating at temples continue, the 
saline draughts may be given; but soon we shall observe the on- 
coming of symptoms indicative of the putrid tendency of the 
fluids; wherefore, a? the weakness increases, we must add stimu- 
lants to the treatment, and lean wholly upon them. 

No. 20. Of camphor 10 grs. 

Carbonate of magnesia 25 grs. 

Water 6 oz. 

Rub the two first together, and add the water gradually. To these 
six ounces add half an ounce of spirits of compound sulphuric 
ether, and half an ounce of syrup, simple, or of orange-peel. 



TYPHUS FEVER. 141 

Of this, two table-spocmfuls may be given every four hours ; 
but as the disease progresses, and prostration becomes more and 
more evident, we must give quinine. 

No. 21. Of sulphate of quinine 2 grs. 

Dilute sulphuric acid 5 drops. 

Syrup, or syrup of saffron 1 drachm. 

Watfer 1 oz. ** 

Every fourth or third hour. 

Great restlessness may be restrained by adding five or ten 
drops, or more, to one of the quinine draughts at night. If opium 
disagree, that is, increase the heat, restlessness, and muttering, 
administer a lavement of twenty drops of tincture of opium in 
water. Or, one or two grains of quinine, taken in pill or powder, 
every four hours, will probably answer a better purpose. 

It should always be borne in mind that the stomach should be 
offended as little as possible. 

If looseness of bowels exhaust, give astringent mixtures. (See 

DiAREHEA.) 

According to the prostration, we must give diluted wine with 
sago, arrowroot, and even calves'-foot jelly, veal or chicken broth, 
beef-tea, etc. 

Wine is seldom required during the first week, but it may 
be, and if it be given too soon, any clear-sighted observer will 
soon see the prejudicial effects in the increased heat, pulse, 
thirst, headache, etc. As to quantity, however cautiously we may 
begin, we must go on boldly, though always watching effects. 
Two or four ounces may be the first day's portion, but it may be 
increased to half a bottle, and even two bottles a day ; and in 
extreme cases, a quarter or half-pint of brandy should be added. 

The urine should be watched daily, as it is sometimes retained; 
when retained, it should be drawn off by an instrument. 

The patient lying on his back motionless, often occasions a 
fretting of the skin, which ends in mortification sometimes, and 
proves a great danger to life, when the fever itself might not be 
fatal. To prevent this, a water-bed is effectual, or water-cush- 
ions, which, indeed, are preferable to the bed, because they are 
more portable. They can be filled with water, and emptied at 
any time, ^o one should travel or reside abroad without one 
of these -cushions, which may make the difference between life 
and death. Painting the reddened back with the alcoholic solu- 



142 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

tion of iodine once daily has prevented^mischief; and Dr. McCor- 
mack recommended, in 1839, a varnish of camphor spirits, of 
lime, and of beeswax. The parts affected are to be coated with 
this — one layer, as soon as the former is dry, up to six layers; 
Thus, he says, a sort of cuticle is formed, and the inflammation 
is prevented from spreading. 

To the secondary or consecutive affections, little can be done 
by the unprofessional reader, for a mixed treatment is often re- 
quired, which demands long experience, and much judgment, too, 
even in the professional practitioner. 

All excretions must be removed as soon as possible, and chlo- 
ride o'f lime or soda solution should be in the bedpan, or it should 
be sprinkled over the -floor, and cloths wetted with it hung up 
about the ^ room. But, above all, pure air (if it can be got) and 
ventilation are essential; and cleanliness must be enforced in 
every possible way. 

And, lastly, never give up a hope of recovery until death has 
closed the scene; for the writer can recall to mind cases where 
the relatives, and even in one cage where his brother medical 
attendants, ha?d refused to force down, as they said, any more 
medicines, wine, etc., when he has had to moisten the lips and 
the dry dark tongue before he put the quinine, mixed in a little 
jelly, into the mouth, to be washed down by wine and brandy 
mixed, and given very cautiously lest suffocation might ensue. 
Several such patients have been clutched, as it were, from the 
very grasp of death; and even were the power of deglutition gone, 
he would still try what might be done by lavements. One re- 
covery amply repays all such labors. 

Bilious Fevers. 

These fevers, as they appear in the United States, require a 
more extended notice than is given to other diseases which this 
work describes. European success will not warrant us in follow- 
ing the modes of practice recommended by the physicians of that 
continent. Ever since European writers have given an account 
of her history in a medical point of view, her people have been 
more or less affected by bilious diseases. In the Neighborhood 
of Rome, these fevers are more prevalent now than Ihey were 
during the prosperity of that city. This is the case with the 



INTERMITTING FEVER. 143 

great Mississippi Valley, with the exception that these fevers are 
less prevalent now than they were during its first settlement, 
owing to the vast improvements in cultivation and drainage. The 
one has retrograded, the other advanced. 

There are three forms of miasmatic fever which medical men 
universally recognize, with some others of less moment, or rather 
which only appear occasionally. The first in the series is the 
intermitting fever, the second the remitting form, and the third 
the malignant form, which, indeed, is little more than an intense 
variety of the remittent. 

These fevers are found in all countries where there are marsh 
lands, extensive bottoms, with much decaying vegetable matter, 
and where there are swamps and stagnant water, and where the 
summer heats have a mean of QQ'^ or even less. Now, as the 
summers of the United States, both on the Atlantic border and 
in the alluvial parts of the interior valley, up to the southern 
edge of the lakes, are so hot as to justify us in designating the 
climate as tropical during the warmer months, it follows that 
these fevers must exist. It is, however, true tha.t their intensity 
diminishes as we ascend to the north. The great heat of Texas 
renders all the marshy parts of that State subject to autumnal 
fevers. The lower and richer parts of the State of New York 
have always been, more or less, subject to these fevers. As to 
the Pacific coast of this country, we have spoken in our disserta- 
tion on the Climate of .the United States with all the distinctness 
which our knowledge will allow. 

iNTERMITTINa FeVER. 

This form of bilious fever, as well as that of the remitting form, 
n'early always begins during the summer or autumn, but it may 
and does occasionally begin during the winter or spring. These 
latter cases, however, generally occur in persons who have had 
one of these fevers during the preceding summer or autumn. 
We have, however, seen numerous cases begin in early spring, 
or even winter, where there had been no previous attack. These 
cases mostly occur in persons who have visited miasmatic locali- 
ties in the preceding autumn. In such instances, the develop- 
ment of the disease is prevented by the cold of winter, but so 
soon as a warm and wet time comes, either in winter or early 



144 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

spring, the malady exhibits itself, and mostly in the form of ague. 
If the subject be now situated in a non-malarial location, and is 
once cured, he will seldom have a reattack. 

We shall consider these fevers in their different characters, 
beginning with the intermitting, then the remitting, and closing 
with the malignant forms of the last disease. 

An attack of intermitting fever generally begins in the follow- 
ing manner : At first there is not much indisposition ; the patient 
sleeps less soundly for a few nights; has a dry tongue on rising 
in the morning, and has occasionally pain in the head or loins, 
with some muscular soreness. In that form which begins during 
the mornings the duration or the return of the paroxysm may 
be looked for every twenty-four hours. When the chill begins, 
there are the following symptoms in nearly all the forms of the 
malady. First, there is gaping or yawning, with a shrunken 
condition of the face and hands, with a slightly bluish color and 
some roughness of the skin, and has a furred tongue. The 
patient now begins to feel chilly, the sensation of cold being felt 
in the back and limbs. His teeth often chatter, and he shakes 
all over. He finds that heat gives little or no relief to these sen- 
sations; being warmly covered is useless. He now passes urine 
often, and it is clear, but not in large quantities. The coldness 
of the surface increases for some time ; but after an hour or two, 
sometimes less and sometimes more, there is a more tolerant feel- 
ing, less pain in the back is felt, and the general aching begins 
to give way. The pulse, from being small and quick, now be- 
comes more regular — is fuller and softer; the face becomes flush, 
and presently the whole body has become warm, the skin smooth; 
the urine now diminishes and is higher colored; the head aches 
more or less, but is relieved eventually by sweating. 

The hot stage is now arrived at, and will generally continue 
several hours. All the symptoms which the forming of this stage 
develops lasts through its period, but often, for a shorter or 
longer period, relief begins by the secretions of the skin becom- 
ing freer. There is felt on the forehead first a gentle softness, 
then moisture, and then sweating. When this last occurs on the 
forehead, there has been, in the mean time, a perspiration ex- 
tended over much of the body, and eventually the sweating Is 
established over the whole surface, which, after a few hours, 
relieves the patient of all fever, and even pain. The urine now 



INTERMITTING FEVER. 145 

becomes freer, and deposits a white sediment on standing. The 
appetite soon returns, and the patient feels himself nearly well. 
He has now a few hours of respite ; but at the same hour on the 
ensuing day, he has to go through the suffering that he had on 
the preceding day. But often the chill does not come on at the 
end of twenty-four hours, but is deferred until the end of forty- 
eight hours, which is called tertian ague, or that which returns 
every other day. Sometimes, but not often, the second chill does 
not return until the end of seventy-two hours. This form is called 
the quartan ague. There are other forms which once in a while 
occur, that our limits will not admit us to describe. Indeed, they 
are not of much importance in a practical point of view. 

It is necessary, however, to state that frequently ague begins 
without any severe chill, there being merely blueness of the face 
and about the nails, or of the hands. These chills are found in 
delicate persons, or where there is a disposition to run into re- 
mitting fever; or where the chill is of a conjestive character. 
These symptoms are much more frequent now, except when 
attending conjestive cases, than they were forty years ago in 
the Mississippi Yalley. Then the disease had more intense cold 
fits, with agues, than now; but as the comforts of civilization 
have spread, these severe symptoms at the outset of agues have 
measurably disappeared. 

Treatment. — ^When the first chill occurs, and the fever following 
is in progress, it is almost impossible to decide how the hot stage 
may terminate; that is, whether the fever will go altogether off, 
or whether there will only be an intermission which will decide the 
case to be of a remitting form. It, however, now becomes proper 
to treat the case according to the symptoms or force of the fever ^ 
and if this be done with decision, what would be a remittent 
will almost certainly be an intermittent or ague. If the patient 
has a high fever — that is, great heat of the skin, with pain in the 
head, and the throbbing of the arteries and strong pulse at the 
wrist — he should be bled from the arm freely, taking one or two 
pints, owing to how well he may bear it; for no blood should 
be taken after a disposition to faint has begun. The operation 
should be performed when the patient is in a sitting posture; 
and before he lies down two or three gallons of warm or cold 
water ought to be poured over him. He should then be re- 
placed in bed without being dried, and moderately covered. This 
10 



146 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

shower bath should be repeated every four hours during the par- 
oxysm. When the subject is feeble, sponging under the clothes 
every few hours will answer, and in these cases blood-letting will 
be improper. Indeed, a large majority of cases will not require 
general bleeding. If, however, there is much pain of the head, 
the patient may be leeched or cupped about the head with great 
advantage. Should the headache be intense, a stream of cold 
water as large as a finger ought to be poured on the side of the 
head for a few minutes. The stream should be poured from a 
distance of eighteen inches. It may first be applied to one side 
and then the other. So soon as the patient has been bled and 
showered with water, the next step in the treatment is to purge 
him pretty freely. There is no purge better during the onset 
of this fever than ten grains of calomel and ten of" twenty of 
jalap. A very good plan is to combine fifteen grains of calomel 
with thirty of jalap, and give half every hour or two in molasses 
or syrup of some kind. Should these doses not act, senna and 
salts may be given; half an ounce of the former and an ounce 
of the latter, with the same amount of manna, should be put into 
a half a pint of boiling water, and let stand half an hour, and 
then strain. One-half can be given at a dose, an hour interven- 
ing, which, with the other medicine, will be nearly sure to ope- 
rate; but sometimes the stomach resists almost every purgative 
that can be given in the form of powder or fluid, in which case 
pills should be tried, of one grain of calomel with two of com- 
pound extract of colocynth. One of these may be given every 
hour until they act. Injections of salt and water may be ad- 
ministered every two or three hours in these cases. One table- 
spoonful of salt, and a pint of cold or warm water, should be 
thrown into the bowels at once. We have often given the fol- 
lowing as a purge in these fevers : Eight grains of calomel, five 
grains of compound extract of colocynth, and the same amount 
of extract of jalap. These can be made into four pills. Two 
should be given, and followed by the remainder in two or four 
hours, should the first two not operate. Sometimes, when there 
is great obstinacy in getting cathartics to act, bleeding the pa- 
tient freely will have the effect, particularly when fainting or an 
approach to it is effected. It is during the early stages of the 
fever when these means will, in the general, be found necessary. 
When there is much disposition to vomit, the best means to 



INTERMITTING FEVER. 147 

arrest it is to give one grain of calomel every half hour, with the 
eighth of a grain of opium, until the vomiting ceases. The opium 
may be dispensed with if there is pain in the head. 

After the foregoing means have reduced the force of the heart 
and arteries, there is softness of the skin and eventual sweat- 
ing, which soon relieves the patient of the paroxysm, and he, is 
now left without fever but feeble; his appetite now returns, and 
he is able to attend to business or take exercise for some hours. 
This state, however, is soon followed by another chill, if no means 
be taken to prevent it. Many physicians were formerly of opinion 
that the second paroxysm should be allowed to occur before any 
means should be taken to prevent the recurrence; but since the 
discovery of quinine they have altered their opinions, and direct 
that a second paroxysm should be prevented. What, then, should 
be done to effect this? We think that it will be safe to admin- 
ister four or five grains of quinine every two hours until twenty 
grains have been taken, beginning so soon as the fever has 
nearly subsided. In this way sixteen or twenty grains will be 
given in six hours, so that we are about sure to effect this before 
another chill will occur. If the patient has taken no mercurial 
during the paroxysm, it will be proper to combine two or three 
grains of calomel with the quinine, or ten grains of blue mass. 
Should the patient be feeble, two or three small glasses of wine 
may be given during the interval. If this course prevents the 
recurrence of the paroxysm, nothing more will be necessary for 
the present. But more of this by-and-bye. If now, however, the 
chill should return, we have again to meet this and the succeed- 
ing fever. There will now be, in general, less headache and 
less intensity of the symptoms. In a very large majority of 
cases it will be unnecessary to bleed. Leeches or cupping may 
be found useful, if the headache be severe, or if there be severe 
local symptoms in other parts of the system. The shower bath 
will now be proper, either cold or warm, or water may be used 
with the sponge. The internal medicines may consist of those 
that will moderate the heat of the skin, and soften the pulse. 
To do this the following may be given, and will, in nearly every 
case, do all that is necessary during the paroxysm : 

No. 22. Calomel 6 grs. 

Pulverized opium 3 grs. 

Ipecacuanha 6 grs. 



148 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Mix, and make six pills or powders, and give one every three hours, 
until the fever subsides. 

Or the following, from Dr. Drake : 

No. 23. Spirits mendersei 6J- oz. 

Spirits nitrous ether ^ oz. 

Camphorated tincture of opium and wine of 

ipecacuanha, each J oz. 

Mix. 

One table-spoonful every two hours will seldom fail to bring 
on perspiration in due time, and may be used safely with or with- 
out the advice of a physician. 

We have now conducted our patient through the second par- 
oxysm, and it again becomes necessary to use the quinine a second 
time. This must be done by giving the same amount in the same 
way as before administered, and, as the recurrence is now better 
understood, it will be proper to give the last dose of the quinine 
about one or two hours before the expected chill. This course, 
in a large majority of cases, will prevent the ague fit. 

When it is found that the ague is of a tertian form, or, in 
other words, comes every forty-eight hours, it will not be necessary 
to give so much quinine in so short a time, as the interval is 
then much longer. In most cases, two grains of quinine every 
two hours will be found sufficient to prevent the looked-for par- 
oxysm. Care must be taken during the administration of quinine 
to keep the bowels in a proper condition. The patient should 
always have one or two stools every twenty-four hours ; and if 
it is found that there is costiveness, half a grain of calomel with 
each dose of quinine will, most generally, make sufficient action. 
It occasionally occurs that diarrhea is connected with intermitting 
fever. When this is the case, the fourth of a grain of opium 
should be given with each dose of quinine, and about a grain of 
blue pill. By this management, the fever will, in almost every 
case, yield, and the patient become convalescent. 

It occasionally and not very unfrequently happens that ague and 
dysentery, or. flux, are united. Now, when this combination occurs 
it becomes necessary to cure the ague while the dysentery is exist- 
ing. Quinine must be given with opium and ipecacuanha, so that 
four grains of quinine, with half a grain of each of the other 
two ingredients, may be given at every dose. The bowels, at the 
same time, must be kept open with Epsom salts, or small doses 



IXTERMITTIXG FEVER. 149 

of jalap or castor oil. Ten grains of jalap will often answer, 
given every two hours, until there is an evacuation effected differ- 
ent from blood and matter. "When the chills have subsided, the 
dysenteric symptoms soon give way, and convalescence takes 
place. Complications of ague with other affections always make 
the disease more difficult to manage, and render it imperative^to 
call on a physician. 

That form of ague which recurs every seventy-two hours, or 
what is called quartan ague, is more difficult to manage than either 
of those which we have spoken of. There is often more intense 
fever, and it is more difficult to control. It often comes on at 
each paroxysm slowly, and the chill is prolonged beyond what we 
find in the other forms; and they seem to have a much greater 
tendency to cause severe congestions of the liver and spleen, 
particularly of the latter. In this form of the malady purging, 
and sometimes bleeding, will be proper, as in the other forms. 
Quinine must be given in larger amounts during the interval, but 
not in greater doses; these may be two, four, or five grains, and 
at intervals of four or six hours apart. Great care must be taken 
that the congestions spoken of do not take place, hence calomel 
purgatives must be repeated frequently; and if even salivation 
should come on, no apprehension need be felt, for it will always 
disappear in two or three days, and will be found to leave the 
patient saved from enlarged spleen or liver, or both. This is 
the form of ague which will be found benefited most by Fowler's 
Solution. Indeed, in all forms of this disease where it is obstinate, 
it is useful and almost indispensable to give some form of arsenic, 
and when combined with quinine, is of great use in chronic agues. 
From five to ten drops of Fowler's Solution, in a wine-glassful of 
cold water may be given three times a day. It should not be ad- 
ministered during more than eight or ten days. "When there is a 
bloated countenance, feet slightly swollen, and some heat in the 
region of the stomach, the medicine must be withdrawn; indeed, 
in general, it is better to give it for some days with quinine, and 
stop before these symptoms supervene. Physicians often, with 
great propriety, administer this medicine until the specific effect 
is produced. 

We have now considered the simple forms of ague, and their 
mode of treatment, but as it frequently happens that the disease 
returns at the end of about ten days from the last fit, it is proper 



150 AMEEICAN HOUSEHOLD BOOK OF MEDICINE. 

to consider what a patient in a convalescent state should do to 
avoid its recurrence. He should be advised not to be exposed 
to the rays of the sun, to night dews, to rain, nor to other im- 
proprieties tending to exhaust the system. Care must be taken 
as to diet, while a sufficient quantity of wholesome food should 
be taken. That which is difficult of digestion ought to be avoided; 
hence, fruits should be taken with great care, and all vegetables 
which are mostly pleasant to the taste without giving much nourish- 
ment, ought to be especially avoided. By taking these precau- 
tions, health is often reestablished without any recurrence of the 
disease. One important matter should not be omitted by persons 
subject to returns of the ague; that is, the condition of the skin. 
In all cases where the subject can bear the cold bath, either in 
the form of plunge or shower, he should submit to it every day 
for some time; for, by this means, he will have the tone of the 
skin greatly improved, and it will be found that health will be 
much sooner established by this process than by the omission of 
this salutary auxiliary. Care must be taken not to advise very 
delicate persons to use cold baths, until it is known that they can 
bear them with comfort. When the patient does not become warm 
soon after the bath, it should then be advised that he use warm 
water with salt, which will be found to answer a good purpose. 

We must now consider the graver form of the disease, which 
is called malignant intermittent, and which is frequently fearful 
in its consequences, causing death in a few hours. 

This form of the intermitting fever begins nearly in the same 
way that others commence. The individual, an hour before the 
beginning of the chill, feels quite well, with the exception of some 
soreness of the limbs and pain in the back, but even these symp- 
toms are frequently wanting. He, at the onset, yawns and gaps 
some, feels cold sensations along his back and running down his 
limbs. There is pain mostly in the head, and there is a general 
shrinking of the surface. The nose and ears are colder than is 
general in chills ; so are the extremities ; and it will be found that 
the blueness of the lips is intense, and often amounts to black- 
ness. This last symptom indicates that a severe case is on hand. 
There is but little shivering, but the patient feels very cold, and 
yawns frequently. He is very weak ; is dull and drowsy, which 
runs, if the case be bad, into profound coma, that in fatal cases 
remains to the last. The pulse is always weak and small at the 



INTERMITTING FEVER. 151 

onset, and continues to get weaker for some hours, or, at least, 
for more than an hour. The urine is suppressed or retained in 
the bladder. The stomach is often sick, and sometimes vomiting 
occurs, rejecting most that is swallowed. The combination of all 
these symptoms precedes the congestive form of intermitting fever, 
because the blood leaves the surface in a much greater quantity 
than in the milder forms of intermitting fever, and is concen- 
trated more in the internal organs. The brain is congested; so 
are the lungs, liver, and spleen, etc. It is the persistence of 
these symptoms which renders the disease dangerous; it hence 
becomes our duty to relieve or terminate this congestive condition 
of the blood-vessels, and conduct the patient safely through the 
fever that follows ; and, finally, to prevent the recurrence of 
another chill of a congestive character, because the patient will 
survive but a very few of them. Indeed, we have never witnessed 
any disease, (cholera excepted,) of an acute nature, more ap- 
palling than this in its worst forms. 

Treatment. — We have looked over many pages with regard to 
the treatment of this malady, and can only say that all the plans 
proposed and put in practice have but too often failed. The cold 
shower bath has been tried, and not without success, and this, too, 
during the cold stage ; but it has often failed. Warm bathing 
with external heat, has been tried, and so has vomiting, and with 
but little success. Purging has had its advocates, but the success 
has not equaled the expectations of its friends. All these modes 
of practice have fallen short of the anticipations of their advo- 
cates. We shall therefore lay down the course which, in our 
hands, has been most successful, and which we think is founded 
in rationality. 

When a patient is taken with congestive intermitting fever, he 
should be placed in bed and covered warmly, but not heavily. 
Next, bottles filled with hot water should be applied, or some 
other warm substance, but not so hot as to injure the skin. We 
have seen great injury done in this way in a few cases ; indeed, 
during the time that the steam doctors flourished, there were 
hundreds and even thousands of patients lost by external heat, 
applied in various forms. The patient now being in a recumbent 
position, and covered as directed, with all the fresh air that 
can be admitted to him, no persons should be admitted but those 
who are necessary to his comfort. The medicines that should 



152 AMERICAN HOUSEHOLD BOOK OF. MEDICINE. 

now be given are, first, five grains of calomel and the fourth of 
a grain of morphine, in the form of a pill or powder, and if there 
be no coma, should be repeated at the end of an hour or two. 
In robust subjects, ten grains of calomel may be preferred to five 
grains ; twenty -five drops of laudanum may be substituted for 
the morphine. A mustard plaster to the stomach will be right, 
with one to each ankle and wrist. Spirits of turpentine should 
be applied to the arms and legs as a liniment. Care should be 
taken not to apply whisky or brandy to the surface, as they in- 
variably produce cold. Dry flannel and gentle friction will do 
more than any wet application. In this manner the surface must 
be treated until the heat returns. 

It now is proper to give the best wine that can be got, and 
whisky or brandy punch ; or these, in some form, should be given 
moderately every few minutes, until it is found that the surface 
is becoming warm, and the pulse more full and regular. To aid 
in bringing about reaction, twenty grains of carbonate of ammonia 
should be combined with an ounce of mucilage of gum arable, and 
the same quantity of simple syrup. Then one table-spoonfui 
should be given every hour during the chill, when it may be 
suspended. Cold water with ice may be allowed as drink, or 
lemonade would be proper. By pursuing this course, the patient 
will generally get safely through the cold stage. The fever will 
then follow, but, in general, will not be so fully developed as 
in cases of simple intermitting fevers. If reaction is without 
sweating, and there is much throbbing of the arteries of the tem- 
ples, with heat of the scalp, it will be proper to apply cold water 
to it, and it may be proper to let a stream of cold water fall on 
the side of the head for a few minutes. 

We attended, many years ago, two cases of this form of fever, 
where the excitement was great after the chills, with strong pulse 
and accompanied with profound coma. In these cases we bled 
largely, until the patients came to themselves, and were almost 
immediately relieved of the coma. 

During the hot stage the same combinations recommended in 
the hot stage of the ague will be very useful, particularly that 
recommended by Dr. Drake. 

The patient has now got through the chill and hot stage, and 
the sweating stage is on him ; every moment is now precious. It 
is the duty of the practitioner to at once begin with quinine, and 



INTERMITTING FEVER. 153 

if the patient lias taken no mercurial during tne stage of excite- 
ment, lie should take, combined with the quinine, a few grains of 
calomel in the course of the interval. "We now do not know 
how long the interval may last, because, if the chill should return 
at the end of twenty-four hours from the beginning of the first 
stage, but a few hours of respite can be expected, and, oi^ the 
other hand, if the next paroxysm should come on at the end of 
forty-eight hours from the beginning, then more time is given to 
prevent its return; but we must not rely on this. It is now nec- 
essary that we should prevent a return, if possible. We must 
then give four or five grains of quinine so soon as the sweating 
stage has begun, and follow it up every two hours, until twenty 
or thirty grains have been taken. Should noise in the ears, 
with dizziness of the head, occur before the thirty grains are 
taken, it should be dispensed with. The patient should be kept 
as quiet as possible all this time, and be allowed pretty freely 
of good wine, or some whisky or brandy, every hour or two, which 
will much aid in preventing a second chill. When the patient 
has approached within an hour of the time when the chill began 
the previous day, he must confine himself to the bed, and take 
twenty-five drops of laudanum, and have moderate heat applied 
to his limbs' until the time for the chill has passed. If, however, 
the chill should come on, the same course must be pursued as 
above laid dow^n for the treatment of the first paroxysm; but if 
the chill does not occur, the bowels should be opened with a 
moderate purge. Two grains of calomel, with five grains of com- 
pound extract of colocynth, may be given every two hours ; or the 
ordinary compound cathartic pills will do very well. Two or 
three will generally be found a sufficient dose. If there be no 
noise in the ears, or lightness of the head, it will be proper to 
continue the quinine, in two-grain doses, every few hours, until 
the next twenty-four hours shall have rolled round; and if then 
there be no chill, the patient should only take some wine three 
times a day during a few days, watching with care whether 
there should be more given about the end of the first ten days, 
w^hen, indeed, it will be better, in a]l cases, to give quinine in 
moderate quantities, with alteratives, for two or three days. 

It may be proper, in severe forms of this malady, to admin- 
ister from forty to sixty grains of quinine during the interval. 
This should be done in severe cases. 



154 AMERICAN HOUSEHOLD BOOK OF. MEDICINE. 

It must occasionally occur that deatli has to be the result espe- 
cially where there has been no proper medication at the outset of 
the disease. The symptoms in fatal cases become inore severe as 
the paroxysm progresses. The limbs are cold, the eyes dull and 
red, the brain oppressed and in an apoplectic condition, with often 
yellowness of the skin, stertorious breathing, and retention of 
urine. Then comes involuntary evacuations of the bowels, and, 
during all this time, the tongue is brown or black in the center; 
the whole mouth dry, with a black matter gathered round the teeth, 
and the breathing becomes difficult. The patient throws his head 
back; his jaw falls; he swallows with difficulty, and, in a few min- 
utes, death closes the dreadful scene. 



Remitting Bilious Fever. 

This form of bilious fever should possibly have been first treated 
of; but, in obedience to custom, we place it after the intermitting 
forms. It belongs to the same regions of the earth that the 
ague does. Sometimes, however, it is met with in drier and 
more elevated districts than this, and, in many situations, runs 
into a continued type; but where this is the case, it but seldom 
effects the mucous follicles; indeed, it has been denied that it ever 
does. In these doubtful cases, it mostly receives the name of 
typhoid, which, we think, is unfortunate, as the remissions are 
not watched with the same care that they would be if rightly 
understood. 

The Remitting Fever is mostly found during summer and autumn. 
In the Valley of the Mississippi it occurs generally during July, 
August, and September. It would be unnecessary to again say 
that it is found wherever the intermitting forms exist in the 
United States. 

The symptoijis generally attending remitting fever are, first, 
a languid feeling during several days, with some thirst and dryness 
of the mouth, particularly in the morning. The tongue is furred. 
There is soreness of the muscles, aching of the back, etc. The 
fever now sets in by a moderate or severe chill, amounting some- 
times to a rigor. In the robust, the chill is apt to be severe; 
in the delicate, and those not much exposed to the rays of the sun, 
it is milder. It may last from a few minutes to an hour or 
more. Even after reaction, chilly sensations often occur whea 



REMITTING BILIOUS FEVER. 155 

the patient moves. The hands and feet are cold, with depressed 
countenance, and with the heat of the ears, nose, and lips under 
the natural standard. The whole countenance has a bluish or 
slightly purplish color, especially the lips. The patient complains 
of aching of the limbs, but more particularly of the head, and 
this last symptom is apt to be severe and continuous. 

After the continuance of the chill for some time, the face 
becomes flushed, the eyes more sprightly, or sometimes red and 
dull. The pulse now regains more than its natural vigor, and 
is increased in frequency, sometimes reaching 120, or even more, 
per minute. The body loses its shrunken condition, and heat is 
diffused over the whole surface. The fever may now continue 
from four to six, or even eighteen hours, which brings the patient 
to nearly the same time in the day when first taken. Should 
the fever last but a few hours, he has a longer interval. But 
not very unfrequently there is scarcely any remission at the end 
of the first twenty-four hours, and the fever recurs and continues 
for many hours, showing, however, a diminution of lesser or 
greater extent at the close of this exacerbation. In this way 
it may go on for nine or ten days, when it may gradually dis- 
appear. But this course is not the one that the fever generally 
pursues. There is, in mild cases, a greater remission, which is 
shown by a slight perspiration about the head first, then over part 
or all of the body. The pulse becomes more natural, the system 
cooler, the headache relieved, and a free or partial reestablish- 
ment of all the secretions and excretions. The fever in these 
milder cases often assumes the form of ague, which now makes 
it safe; but sometimes even ague is avoided, and this very often 
when the proper medication is used. There is one symptom 
which occurs, though not often, in this fever, that has been too 
much overlooked ; that is general soreness, by reason of which 
the patient can not bear to be moved without great suffering. 
This symptom, however, belongs almost always to the malignant 
form of the fever, and is a very grave symptom. Added to 
other head symptoms is delirium, which, indeed, often belongs to 
this fever. 

All this time the urine is deficient, except during the remis- 
sions, when it becomes more copious, and deposits a sediment, 
mostly of a whitish color. As has been remarked, the tongue 
is coated, especially in the back part and the center, and toward 



156 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

tlie close of the disease, in bad cases, becomes dark yellow-brown. 
Black and dry sordes collects around the teeth; that is, black 
matter. Once in a long time, a little back of the point of the 
tongue, it contracts, extending to the end. This is called a 
pointed tongue, and is a most grave symptom. There is, occa- 
sionally, considerable costiveness, with or without vomiting; and 
then, again, diarrhea is present early in the malady. Toward the 
close, when a fatal termination is about to take place, there is 
picking of the bed-clothes, slipping down in the bed, with tremb- 
ling of the limbs, and coma or stupor. The discharges from the 
bowels are involuntary; not unfrequently violent delirium, with 
stertorious breathing and death. Yet sometimes, when many of 
these symptoms are present, the patient will eventually overcome 
them and recover; but when they all exist, hope must be lost. 

Treatment. — During the first chill, or when the state of excite- 
ment is on, it will be a most difficult matter to decide whether 
the case will terminate by a complete intermission, forming a 
case of ague, or will only remit, and soon reassume its former 
violence, and thus become a regular remittent. It, however, 
becomes necessary to treat the case according to the symptoms, 
or force, of the fever ; and if this be done with decision, what 
would result in a remittent may be forced into an intermittent. 

If the patient has high fever — that is, great heat of the surface, 
with strong pulse and severe headache — he should be bled from 
the arm until the point of fainting. To effect this easily, the 
patient should be raised in the bed; and as soon as circumstances 
will allow, he should be taken out of bed, and a gallon or two of 
cold or warm water poured over him, the stream falling on his 
head. He should then lie down, either with or without drying. 
This may be repeated every three or four hours during the par- 
oxysm. But after a few days it ceases to have much influence; 
it can then only be used with advantage once in twenty-four 
hours. In m.ost cases, simple sponging, when the patient is lying, 
will be best. A wet towel will answer every purpose. It should 
always be extended over the whole body. It is very common to 
wet the face and limbs, often without going over the whole body, 
which, in our opinion, is a great error; the body is the hottest 
part, and therefore needs the application most. By the judicious 
management of the external application of water, bleeding be- 
comes unnecessary in most cases. After the influence of water 



REMITTINa BILIOUS FEVER. 157 

has ceased, it will be found to give mucli comfort to the patient 
to oil liim all over with sweet-oil once a day. Before leaving 
the external use of water, it is proper to state that Avhere there 
is much headache, and all has been done by the general applica- 
tion of water that is proper, there will be great benefit derived 
from pouring a pitcher of cold water on the head, as recommended 
in ague, etc. The patient will complain of this application much, 
but will soon feel greatly relieved. It must be recollected that 
bleeding is not always needed at the beginning of these fevers; 
but it is seldom that either the cold or warm shower should be 
dispensed with; and in the most feeble, either cold or warm water 
should be used, with the sponge. 

Now, when the patient has been treated in this way, another 
thing must be attended to ; that is, the state of the bowels. These 
are, in most cases, in a constipated condition, and are often moved 
with difiiculty. The same course must be pursued to bring about 
purgation that has been recommended in intermitting fever. 
When there is a fi^ee action of the bowels secured, some medicine 
should be directed to bring about the natural action of the skin. 
One of the most agreeable ways to effect this is to give the effer- 
vescing draught, which can be made in the following way: 

No. 24. Of bicarbonate of potash 2 drs 

Water 4 oz. 

Mix. 

Then of the tartaric acid, one drachm and forty grains; this put 
into four ounces of water. Add a tea-spoonful of sugar to the 
acid, or more, if the patient wishes. Of these mixtures, put two 
table-spoonfuls of each into separate glasses, and add water 
until, when brought together, they will make nearly a full glass. 
Now add one to the other, and drink when effervescing. This 
may be taken every two hours when the fever runs high. The 
common soda poAvders will answer nearly as good a purpose; but 
there is one effervescing draught that is better than any other; 
that is, one table-spoonful of lemon-juice put into two of water, 
then twenty grains of bicarbonate of potash, dissolved in three 
table- spoonfuls of water. Pour one into the other, and drink 
when effervescing. This may be given every hour or two with 
great advantage, particularly where there is much irritation of 
the stomach. The combination should be made pleasant to the 
taste by sugar or syrup. The following is strongly recommended 



158 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

by Dr. Drake, in his great work on tlie ^'Diseases of the Interior 

Valley": 

No. 25. Spirits of menderseri 6J oz. 

Spirits of nitrous ether J oz. 

Spirits of camphorated tincture of opium. ^ oz. 
Mix, and give one table-spoonful every two hours. 

It will often be proper to give ten grains of Dover's powder 
once a day. This, given at bed-time, often aids in producing 
sleep, which is a most desirable thing, if possible. Often, too, a 
combination of extract of hops and that of hyoscyamus, in equal 
portions, will be found to give great relief, in doses of three grains 
each, given at eight or nine o'clock in the evening. This pre- 
scription is especially useful in the treatment of female cases. 

Should the fever persist, attention must be given daily to the 
condition of the bowels, so that they may act two or three times 
every twenty-four hours. This is best brought about by giving 
two or three grains of calomel every six hours ; and should it 
not operate, then a table-spoonful of castor-oil may be given 
every afternoon; or ten grains of jalap will mostly answer a 
better purpose, which may be repeated every four hours, until 
it acts. The compound powder of jalap, given in twenty grain 
doses, will move the bowels as well, if not better, than any other 
purgative. The dose may be repeated every few hours, until the 
object is effected. 

This is a description of what should be done in a simple case 
of remittent fever, and it very often comprehends all that mil 
be necessary; still, cases occur where we have to use other means, 
or even to lay aside much which has been above proposed. We 
will meet with a case occasionally where calomel must be dis- 
pensed with, and then the blue pill must be resorted to, in such 
doses as the patient can bear. In these delicate cases a physician 
of skill should be consulted, and, if possible, have the treatment 
of the case. 

This fever, when well treated, is very apt to gradually run into 
the intermitting form. Of course, it must then be treated as 
simple ague. 

Sometimes the results will be different from that portrayed. 
Instead of a mitigation of the symptoms, the fever resists all the 
means that can be used. At the onset of this fever, if the pulse 
be very rapid, its motion irregular, and vibrates under the finger, 



REMITTING BILIOUS FEVER. 159 

at the same time that the heart has a slightly tumultuous ac- 
tion when the ear is applied over it, without the healthy contrac- 
tion of the ventricles, the case should always be considered as 
grave. The skin, in these, cases, is often slightly yellow, and 
sometimes has a deep hue ; the eyes, too, are tinged with bile. 
There is frequently intense headache, with nervous twitching of 
the muscles of the arms, and the tongue has a tremulous motion, 
and a brown or black coating in the center, becoming lighter near 
the edge, and it is generally dry. The urine is scanty, and the 
evacuations from the bowels have a dark brownish color, and are 
offensive and thin. Occasional stupor is present, with delirium 
at times. When a number of these symptoms occur in the same 
case, there is much danger, and it needs the most determined 
treatment to prevent death. It is, however, fortunate that they 
are rare. They constitute what is called mahgnant remittents. 
This name characterizes their severity. The writer, during a long 
experience, has met with but few of them; but in the southern 
parts of the United States they are more common, and are often 
fatal. 

At the onset of cases of this form of fever, a free dose of calo- 
mel of ten or twenty grains, with the same amount of jalap, 
should be administered, and, if necessary, repeated every two 
or three hours, until free purging is produced. These remedies 
may be aided by injections. Before the bowels have been freely 
moved, it is necessary to consider whether bleeding should be 
resorted to. If the pulse be strong and the head much pained, it 
may be best to bleed first, as is spoken of at the beginning 
of this chapter. Cupping or leeching would be found of great 
use in some cases. After this course of depletion by purging 
and loss of blood, it will be proper to pursue the treatment by 
giving broken doses of calomel and ipecacuanha. About a grain 
of each in the form of a pill or powder, with half a grain of 
opium, should be given every four hours, until there is a mitiga- 
tion of the symptoms. The opium may be used or not, owing 
to the condition of the bowels or head. The effervescing draught 
should be given every few hours all this time. The cold or warm 
shower should be used in this form of the fever, as in other cases. 
If the force of the fever moderates, with a softened pulse and 
moist skin, it becomes of the first importance to give free doses 
of quinine until another paroxysm occurs, when it may be left 



160 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

off for some hours. When it is given, it will be best to direct 
four grains, every two hours, until twenty grains be taken; or even 
more may be administered if the head does not seem affected by 
it. If there be mitigation of the disease by diffused perspiration 
and general relief, hope may be entertained, but we must not be 
too sanguine. 

The membranes of the brain often, in these severe cases, where 
there is coma or intense headache, become inflamed or congested, 
and effusion occasionally occurs, and fluid is thrown into the ven- 
tricles of the brain. Of course, when this latter once takes 
place, death will result. 

It will be found, when there is much disturbance of the brain, 
that blisters on the forehead or on the back of the neck will be 
useful. The hair should be cut close or shaved off; then cold 
applications can be used with advantage, or the scalp may be 
blistered. We have occasionally found the tincture of iodine 
useful, by frequently applying it to the scalp, through hair, or 
otherwise. 

When the fever assumes a typhoid type, in its advanced stages, 
the strength of the patient must be sustained by a few table- 
spoonfuls of soup, every two hours; that is, if the stomach can 
bear it without revolting; other nutritious substances should be 
directed, such as sago, arrowroot, etc. In the mean time good 
wine must be given, in moderate quantities; and in its absence, 
whisky punch, or brandy and water, can be used. It should 
always be recollected that no more stimulants ought to be used 
than will keep the pulse at about the natural standard; for, by 
pushing them to excess, great harm is done. In the latter stages 
of fever, all treatment should be of the most gentle kind. Time 
must be given with those medicines that will neither debilitate 
nor over-stimulate. 

If salivation occurs in the treatment of bilious fever, it may 
mostly be considered a good omen; but mercury should seldom 
be given for the purpose of effecting salivation, because, in many 
cases of fever, particularly of the continued type, no such result 
can be effected; hence mercury, in such cases, may be given to 
excess, and poison the patient. What should be done with this 
powerful agent is, to keep, by the use of it, the abdominal and 
other secretions in as healthy a condition as possible. Pretty 
free and frequently large doses should be given at the beginning » 



REMITTING BILIOUS FEVER. 161 

of these fevers, especially in robust constitutions, and those who 
are full livers. Nearly all persons connected with boating on the 
waters of the Mississippi need large doses of calomel at the be- 
ginning of their bilious fevers. 

Sometimes remitting and intermitting fevers are combined with 
dysentery. In such combinations, it may be laid down as a i?ule 
that the dysentery will not get well unless |:he fever attending be 
first subdued. Then it is proper to treat the accompanying fever 
as though the dysentery was not present, by quinine, etc., and 
when the fever has given way, the dysentery will be easily 
managed. Yet the dysentery will have to be treated before the 
fever can be relieved, so that its violence will be mitigated; hence 
opiates, with ipecacuanha, will have to be given, accompanied 
with fomentations to the bowels. 

When ague is not properly treated, or not treated at all, it 
runs into the remitting form. The chills come on regularly for 
some time, but as the patient becomes weaker, the chills become 
gradually weaker, until they are scarcely felt, or disappear alto- 
gether, and sweating ceases entirely, which had hitherto miti- 
gated the fever every or every other day ; but now the skin 
becomes dry, the liver enlarges, and the appearance of bile in 
the discharges from the bowels nearly disappears; the spleen, too, 
is often found congested, if not inflamed. The countenance now 
becomes, bloated and sallow; the feet and legs begin to swell; 
and often general dropsy takes place, or rather what is called 
anasarca. This is occasionally accompanied with dropsy of the 
abdomen. The following case will show the results that occa- 
sionally occur in such cases: 

A gentleman, fifty years of age, who lived in the western part 
of Cincinnati, and in a location where ague is common, took that 
disease, and called on an empiric of the homeopathic school to 
attend him. The empiric gave him powders through seven weeks, 
at the end of which time his chills had disappeared. His com- 
plexion was sallow; his lower limbs were swollen, and this efi'u- 
sion of water had spread throughout the cellular membrane ; and, 
beyond this, two or three gallons of watery fluid had collected 
in the cavity of the abdomen. We saw and prescribed for this 
patient, and, after an attendance of some weeks, we succeeded in 
curing him; and now, at the distance of twelve or more yearSj. 
he is comparatively a healthy man. 
11 



162 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Similar cases to this occur almost every-where that ague is 
found. They grow out of neglect and bad treatment, or in locali- 
ties where malaria has great intensity. They have to be treated 
with much care, even where there is no effusion of water in the 
belly; and where it is possible, so soon as they get well enough 
to travel, they should be sent to a region where ague never ex- 
ists ; there, with alteratives, they will finally recover. It must 
not be forgotten that in many swampy districts of this country 
chronic liver and spleen diseases continue almost through the 
miserable lives of a considerable portion of the inhabitants. In 
cases of liver and spleen diseases, and those other symptoms 
spoken of as following bilious fevers, the patient should take a 
blue pill of five grains, two or three times a week, and with them 
enough of some cathartic medicine to keep the bowels open, once 
a day; and if diarrhea should at any time occur, then half a 
grain of calomel and half a grain of opium, and the same amount 
of ipecacuanha can be taken after each action of the bowels, 
which will, in general, check the diarrhea after a few doses. 

Yellow Feyer. 

The Yellow Fever is a form of disease in many respects dif- 
ferent from either the graver forms of intermitting or of remit- 
ing fever. These last are found in all countries where there are 
rich alluviums, or bottom lands, and marsh or swampy localities, 
not only within the topics but far into the temperate zones, as 
has been shown in the article on climate. The yellow fever sel- 
dom extends to the 40th parallel in either hemisphere ; and never, 
only where the mercury reaches 79° or 80° of the thermometer, 
during a period of two or three months ; hence, it will never appear 
at San Francisco, or indeed in but few spots on the north Pacific, 
coast. When frost once appears, it disappears for the season. 
Within the tropics it begins earlier than north or south of them. 
At Vera Cruz it occurs in April, and at Havana in May, while 
at New Orleans never before July. This fever, too, is not known 
in all marshy or alluvial districts in hot countries, as the in- 
termittents are. For instance, it is mostly known around the 
Mexican Gulf, on the Mississippi, in the West India Islands, in 
Western Africa, some of the cities of Spain, etc. It seldom or 
never is endemic or epidemic out of large towns or cities. East- 



YELLOW FEVER. 163 

ern Africa has never been visited by this fever, neither have the 
East Indies. 

The yellow fever seems to follow the tract of human inter- 
course in those localities favorable to it, and, in hot seasons, has 
often visited Philadelphia, sometimes New York, and has been as 
far north as Boston, and even as Portland, in the State of Maine. 
It but seldom attacks more than once the same individual. In- 
fants are amenable to it, but when once subjected to it, they never 
or seldom have it again. Of persons who have lived in localities 
where it never or seldom appears, and visit points where it rages, 
a large number take it, and many fall victims to it, while those 
who are acclimated are seldom attacked. 

It would seem from the information which we derive from Dr. 
Drake, that those patients who have been treated in hospitals are 
more apt to die than those who have not; for while nearly half die 
in hospitals, the rate of mortality out of them is often but one in 
eight, or even less. Patients with any disease, however, treated 
in hospitals, are less apt to recover than those treated in private 
practice. 

Symptoms. — The yellow fever begins generally during the night, 
and is frequently ushered in by a chill or rigor; but this symp- 
tom is not constant. The most characteristic symptoms are pains 
in the back and limbs ; the breathing is hurried, with hot and 
dry skin, frequent pulse, and flushed face; the eyes are red and 
watery, and the tongue moist, with a white fur; the throat is 
often sore, and there is sometimes nausea, with or without vomit- 
ing, and weight at the epigastrium. Cold drinks are grateful, and 
much desired. Costiveness is nearly always present, and there is 
great restlessness, with frequent delirium, and occasional stupor. 
In a majority of cases, the symptoms connected with the stomach 
do not become developed before twelve or twenty-four hours have 
expired, when they become very prominent. Burning pain is ex- 
perienced, or weight and tension, or a vague sense of oppression. 
Headache is nearly constantly present; and when there is vomit- 
ing, it is painful. The febrile symptoms continue from a few hours 
to three days, and sometimes to four or five. Having run its course, 
the fever subsides, and a great amelioration ensues. The skin now 
becomes cool; the pulse nearly or quite natural; the stomach, too, 
is now quiet, and the respiration natural ; the pains of the head, 
back, and limbs disappear, and the patient is cheerful, and now sits 



164 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

up in bed, and says lie is well. Sometimes convalescence dates 
from this condition ; but alas ! but too often it is a delusive hope ; 
the great struggle is yet to come. 

This cessation of fever is not equal to that occurring during 
remitting fever. The disease seems to be going on, notwithstand- 
ing the absence of fever. The struggle against the poison has 
ceased for a time, but, if you press on the epigastrium, you find 
great soreness, and the patient suffers. The eyes have now often 
lost their redness, but become yellow or orange-colored, which 
color gradually extends over the whole body. The tongue is 
now brown-black, or red and chapped. The pulse is slower than 
in health, and sometimes falls to forty beats per minute. The 
last stage is completely formed by the irritability of the stomach 
being reestablished. This condition of the case may come during 
the first twenty-four hours of the remission, with a purplish skin 
and receded circulation from the surface, while the heart and 
great arteries beat tumultuously. The urine, at first scanty and 
high-colored, now becomes more copious and clear, but still is 
sometimes suppressed. At this stage of the malady, hemorrhage 
occasionally results, and is thrown out from difi'erent parts of 
the body, especially from the mucous membrane; blood is dis- 
charged from the gums, and fissures of the tongue, as well as 
from the back part of the mouth and nostrils. Sometimes it is 
vomited or passes by stool, or with the urine. Extravasations 
appear on the skin. The extreme distress and irritability is now 
replaced by apathy, and the countenance shows a quiet resigna- 
tion or gloomy indifierence. The pulse nearly ceases ; the breath- 
ing becomes slow, with sighing and hiccup; the skin cold and 
clammy ; the bowels discharge large quantities of dark matter, 
with a disagreeable odor, which also arises from the body; the 
eyes sink, the countenance collapses, and then death takes place 
either quietly or amid convulsions. Patients frequently die with- 
out either yellowness of the skin or black vomit. Yet these are 
mostly part of the phenomena ; the latter does not, however, make 
its appearance in general until the second or third stage. At 
first the matters ejected are those that have been swallowed, and 
then a little bile. These are often acrid, so that they inflam.e the 
back part of the mouth and the gullet. The black matter, in 
flakes, is first thrown up in small quantities, but afterward in- 
creases, and frequently becomes enormous. This matter seems 



YELLOW FEVER. 165 

to be sometimes retained long in the stomach for want of power 
to throw it up. 

Treatment — Many cases of this fever are not amenable to the 
influence of medicine, for, so rapid is its progress, that the patient 
receives a death blow at the very beginning of the attack. There. 
are others, again, which are so mild that they readily yield to oilii- 
nary treatment, or the patient may recover without any treatment. 
Indeed, under every kind of treatment there are many deaths and 
many recoveries. In hospitals the disease is more fatal than in 
private practice. The fatal cases in hospitals range from one-half 
to less, but in private practice there is from one in five up to one 
in twenty-six lost, sometimes more, sometimes less. 

Very early in the disease, when there is no irritability of the 
stomach, and no tenderness of the epigastrium, and where it is be- 
lieved that the stomach retains much undigested food, it is proper 
to give a gentle emetic of ipecacuanha. When there is great heat 
and violent arterial action, with headache, etc., it is often best to 
bleed the patient, and sometimes freely ; but to derive benefit from 
the use of the lancet, it must be used early, never, probably, after 
thirty-six hours, and always by the direction of a physician. 

A mercurial cathartic, says Dr. Wood, is always indicated; from 
ten to twenty grains of calomel should be given without delay, 
and followed in an hour or two by an ounce of Epsom salts, or 
some other saline cathartic. In some instances, castor-oil may 
be given with advantage. We have heard it said that an ounce 
or two of almond oil, with the same amount of lemon-juice, aids 
much in efi'ecting purgation. If the constipation remains obsti- 
nate, recourse may be had to senna and manna, with Rochelle 
salts. Half an ounce of the first, and an ounce of each of the 
latter, infused in half a pint of boiling water, can be given at two 
doses, an hour apart. In the meantime, one grain of calomel must 
be given, without regard to other medicines, every hour, until the 
bowels act. We have seen much, very much advantage from this 
medicine given in this way in cases of obstinate constipation. In- 
jections should be directed every two hours, of a table-spoonful of 
common salt, or Epsom salts, in warm water. A pint or two of 
water should be used each time. After the bowels have been thor- 
oughly moved, they should be kept open during the remainder of 
the fever by moderate doses of rhubarb and magnesia, which an- 
swer a good purpose. A tea-spoonful of the latter, with half the 



166 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

amount of the former, given once in four hours, will answer a good 
purpose. Moderate doses of the saline cathartics could be used 
often for purging ; magnesia, the seidlitz powders, a bottle of the 
citrate of magnesia would answer well for this purpose ; injections, 
too, could be used. 

It has been stated that a mercurial purgative should be given 
at the outset of the disease under consideration, and that, in con- 
stipated cases, it should be given every hour until the constipation 
is removed ; but we have said nothing as to the continuance of 
the mercurial course until salivation is brought on. To effect 
this, one or two grains of calomel must be given every hour 
during the continuance of the disease — probably one grain as a 
dose is preferable to more. It will be found, when there is much 
irritability of the stomach, that the sixteenth of a grain of opium 
would be useful with each dose. It will be best to give this medi- 
cine in the form of pill. Should salivation come on, it may be 
concluded that the patient will get well with proper management. 
Often the disease is so violent that no mercurial effect can be ob- 
tained ; still, it is best to continue the calomel to the close of the 
disease, whether fatal or otherwise. When inflammation of the 
stomach comes on, more calomel and more opium should be given. 
The dose should be doubled, and, in bad cases, a little more than 
doubled. In these cases, a large blister ought to be applied over 
the stomach ; and when it has risen, powdered acetate of morphia 
should be sprinkled over the blistered surface at the pit of the 
stomach. The patient must be sustained by soups, or a little milk 
and water, taking care not to overload the stomach. A table- 
spoonful of milk, with one of lime-water, may sometimes be taken 
every hour. Should the system show signs of sinking, it will be 
necessary to use the best wine that can be obtained, occasionally 
brandy broths, etc. Stimulants are not specifics ; all they can do 
is to prevent death until the system has worn out the disease ; and 
we think these remedies are mostly pushed too far, and do more 
harm than good. Quinine will do better than any other tonic, 
given in doses of two grains every four hours. Of the stimulants, 
wine is the best. If any one of these remedies create burning, it 
must be laid aside. Opium, in this condition of the system, should 
be given freely. 

It must not be forgotten that, in delicate constitutions, when 
there is much pain in the head, or tenderness of the epigastrium, 



YELLOW FEVER. 167 

leeclies should be used, or cups, during the first stage, especially 
■where bleeding is inadmissible. In all cases when it is possible, 
a physician should be called at an early period of the disease. 

It must be recollected that in all cases of yellow fever, the ex- 
ternal use of cold or warm water must not be neglected at last 
during the hot stage. The patient should be showered with cold 
or warm water every three or four hours ; the former will do better 
than the lattej* with the robust, while the weak or delicate will be 
most benefited by the latter. After the stage of excitement is 
over, water will be of little use ; and when used, it should only be 
with the sponge, and only when there is considerable heat of the 
surface. 

Great deference must be paid to those physicians who live far 
South, and who have seen much of this disease. Many of these, 
within the last ten or twenty years, have come to the conclusion 
that the mercurial treatment is not beneficial, and therefore have 
abandoned it, either altogether or in part. They tell us that pa- 
tients who have been salivated, when laboring under the yellow 
fever, mostly get up slowly ; and the mortality is often greater 
when treated by mercurials, combined with other medicines, than 
when this powerful agent is left out of the prescriptions. 

A number of distinguished physicians of New Orleans, and other 
parts of the South, have now, for a good many years, made quinine 
the principal medicine in the treatment of this disease. Among 
these we find Doctors Stone, Mackie, and Harrison, of New Or- 
leans. The first of these physicians gives it in the first remission, 
even before the headache has subsided, and finds that it lessens 
the heat and force and frequency of the pulse, when given in this 
stage. He bleeds occasionally, and generally cups, to relieve local 
symptoms ; and purges moderately mth calomel, etc., before giv- 
ing the quinine. He then gives frequently five or ten grains of 
the quinine, until roaring in the ears takes place. He says he has 
seen black vomit occur after the administration of this medicine ; 
but that the number of instances is very small, and it seemed to be 
brought on by the imprudence of patients getting out of bed too soon. 

Dr. Mackie bleeds and cups, and opens the bowels by injections, 
and then gives, at a single dose, twenty or thirty grains of the 
quinine, which, in general, he finds sufficient. If the stomach be 
irritable, he administers it by injection. He cups again, if neces- 
sary, and repeats the sulphate in smaller doses. 



168 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Dr. Harrison began tlie treatment hj quinine in the same year 
with Dr. Mackie — that is, in 1839 ; and he is, or was, a zealous 
advocate of the cours*e. 

Now we feel strongly impressed with the notion that this prac- 
tice is, taking it altogether, the most rational of any that has yet 
been proposed; and as it has been adopted by the distinguished 
physicians named, and many others, we can not help recommend- 
ing it as among the very best plans that have yet been proposed. 
The success which we are informed has attended its adoption war- 
rants us in this belief. It has, too, the advantage of being simple; 
even in the hands of a nurse it may be resorted to with safety. 
Every one acquainted with sickness knows very well what is meant 
by roaring in the ears, and also understands what local pain is, and 
that over or near it cups should be used ; and when there is great 
fever, that the lancet may be safely used, at least at the onset; 
and this is especially so after the first twenty-four or thirty-six 
hours of this dangerous disease. 



Inflammation 

is of two kinds— phlegmonous and erysipelatous. 

By phlegmonous is understood an inflammatory circumscribed 
affection of the skin, with more or less of swelling, of bright red 
color, pain and distension ; while erysipelatous is characterized 
by its tendency to spread over the skin or over the surface of 
membranes by its attacking different parts of the body, either 
simultaneously or by metastasis, and by its contagious and infec- 
tious character. 

Phlegmon is seated in the true skin, at its inner surface, and it 
soon extends to the adjoining parts of the cellular membrane, the 
swelhng thus extending in all directions. Shooting and throbbing 
pains, with a full, hard pulse, and great thirst, attend. It termi- 
nates either in resolution (gradual disappearance), or else matter 
is formed, or some affusion or adhesion, or gangrene results. 

Causes, predisposing.— Hoo great fullness of body; excess in 
eating or drinking; the sanguine temperament; defective or dis- 
ordered action of the liver, kidneys, or skin, whereby the blood 
is not adequately purified. The exciting causes are, chemical or 
mechanical injuries, over-exertion, etc. 



INFLAMMATION. 169 

Treatment — Our object is to procure resolution as a termina- 
tion — the happiest result. This is to be done very often by 
blood-letting, purgatives, cold applications, and low diet. The 
blood-letting should be according to the symptoms of vascular 
excitement, and if any one is near wbo can be trusted to bleed, 
blood should be taken from the arm until the patient feel rather 
faint. Then the calomel blue pill and colocynth pill, ordered in 
the treatment of inflammatory fever, should be given, and its 
free operation secured by adding one drachm of Epsom salts to 
each saline draught, to be taken every four hours, till the bowels 
are free. Then omit the Epsom salts, and continue the saline 
draughts, with one-sixteenth of a grain of emetic tartar in each 
draught, while the bowels are to be kept acting freely. Cold 
applications should be made by means of a single piece of fine 
linen, frequently changed, and the vapor must be allowed to pass 
off freely, or the cold application soon changes into a warm fo- 
mentation. But frequently cold applications either cease to give 
comfort, or they actually add to irritation, in which case tepid 
applications (85° Fahrenheit) must be selected; they do not 
stimulate like heat, and they do not occasion painful reaction 
like cold. 

Leeches may be applied near to the inflamed part, after the 
blood-letting, if necessary; and if no blood be drawn by the 
lancet, some fourteen to twenty leeches should be applied. 

If, in spite of all these, the part throbs, and perhaps the pa- 
tient shivers, then suppuration is coming on. Then warm fomen- 
tations (of 92° to 98° Fahrenheit) are preferable; they relax the 
skin and soothe the pain. When the swelling shows a thin pro- 
jecting part, it soon bursts, or it may be opened; the matter is 
discharged, and, after a few poultices, the part heals, if the pa- 
tient's constitution be good. 

During the whole time the inflamed part must be kept strictly 
at rest, and raised above the level of the body, if the swelling is 
situate in either of the legs or arms. 

If these measures to promote resolution are not successful, and 
suppuration do not ensue, the part may terminate in gangrene 
or mortification ; then the inflammatory redness assumes a darker 
tint, even to purple and blue — the heat, sensibility, and pain 
leave the part, though it may rather increase in size — and serum 
is effused, which serum sometimes exudes through the skin, and 



170 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

o 
forms blisters on the cuticle. If the gangrene do not stop, the 
parts become soft, cold, and corpse-like, emitting fetid odors, as 
from a dead body in a decomposing state ; but if it be about to 
stop, the dark color is no longer diffused, but a healthy circula- 
tion is reestablished up to the very portion of the gangrened 
skin, and a bright red line, called the line of demarcation, sepa- 
rates the living parts from the dead. 

Our treatment of gangrene must depend on the state of the 
patient. If he is young, and of vigorous habit, with pulse still 
full, hard, and strong, then still we must bleed, purge, and give 
salines, applying leeches and fomentations locally; but if the 
pulse be quick and feeble, and vital power seem deficient, then 
wine and opium, beef tea, and other fluid nutriment. For medi- 
cines, the bark, sulphate of quinine, ammonia: 

No. 26. Of sulphate of quinine 2 grs. 

Tincture of opium 2 to 5 drops. 

Compound spirits of ether i" dr. 

Compound spirits of ammonia -J- dr. 

Decoction of bark 1 oz. 

Three or four times in the day. Or this : 

No. 27. Decoction of yellow bark 7J- oz. 

Sesquicarbonate of ammonia. i dr. 

Syrup. J oz. 

A sixth part two or three times a day. If these can not be 
readily procured, we would recommend 

No. 28. Quinine, in the form of pills 2 grs. 

taken every three or four hours. 

If necessary, a little opium may be combined with each dose. 

The stomach, in cases of gangrene, is often irritable, and bears 
nothing well. 

If the opium and wine are doing good, the delirium and rest- 
lessness are diminished. If these symptoms are increased, dis- 
continue, or give less of the wine or opium. The dose of opium 
is forty drops of the tincture at night ; and the wine can be tried 
as was recommended in typhus. For local applications, the yeast 
poultice, thus made, or one of the two following: 

No. 29. Take of beer yeast, and water heated 

to 100 degrees, of each 5 fluid oz. 

Flour 1 lb. 



INFLAMMATION OF TKE BRAIN. 171 

Mix the yeast with the water, and add the flour, stirring the 
whole. 

The Cliarcoal Cataplasm. 

No. 30. Of boiling water • 10 fluid oz. 

Bread 2 oz. 

Powdered linseed 10 dr. 

Powdered charcoal 3 dr. 

Let the bread stand in a little water near the fire ; then mix it. 
Add the linseed by degrees, stirring the whole into a poultice. 
To this mix in two drachms of the charcoal, and sprinkle the rest 
over the surface. 

Cataplasm of CJilorinated Soda. 

No. 31. Of boiling water 6 fluid oz. 

Powdered linseed 4|- oz. 

Solution of chlorinated soda 2 fluid dr. 

Constantly stirring, add by degrees the linseed to the water; 
then mix in the chlorinated soda. 

This last corrects the fetor of the discharge, or of the gangrened 
part. 

Erysipelas. (See Diseases of the Skin.) 

Inflammation of the Brain, or Phrenitis, 

may begin with acute pain in the head and delirium, or with 
bilious vomiting', or with convulsions. The symptoms are sharp 
head pain, throbbing of the temporal arteries, brilliancy of eyes, 
contracted pupils, very red face; sound and light can not be 
borne; watchfulness, hot and dry skin, dry tongue with a white 
fur, violent delirium, great thirst, nausea, and vomiting; bowels 
confined. After two or three days convulsions are followed by 
stupor and low muttering ; the eye loses its sight, and the pupils 
dilate ; then palsy, twitchings of the muscles, involuntary passage 
of stools ; urine retained, perhaps ; cold sweats and death. 

Duration to two or three weeks, and the terminations are re- 
covery, palsy, or insanity. 

Causes. — Coup de soleil, or exposure to strong heat, bearing 
down on the head, irritation of stomach, intemperance, suppres- 
sion of habitual discharges, and of other diseases, dentition in 
some persons. 

Treatment must be prompt and decided. Copious and repeated 



172 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

bleeding from the arm, and blood is to be extracted unto ap- 
proach of fainting ; then cupping or leeches to the temples. 

Active purging with the salts and senna mixture, or by a drop 
of croton oil put on the tongue. 

Then give these powders — anti-inflammation powders: 

No. 32. Calomel Bijss. or 50 grs. 

Tartar emetic 1 gr. 

Mix well, and add powdered gum- 
arabic 5j. or 60 grs. 

Mix all well together, and divide into sixteen equal doses. 
One to be taken every four hours, until signs of the mercury 
affecting the system become manifest. These are a swelling of 
the gums, the upper edge swelling, and showing a white line ; fetor 
of the breath, a coppery taste in the mouth, and flow of saliva. 

Then discontinue the powders immediately, and give saline 
draughts, using a gargle composed of 

No. 33. Tincture of myrrh J oz. 

Of catechu 3 drs. 

Honey or honey of roses J oz. 

Water 7 oz. 

Mix. To be frequently used. 

When the signs of excitement give way, and stupor and other 
signs of the second stage exist, a blister to the shaven head; and 
if there is great weakness, give wine, ammonia, with beef tea, etc. 

During the earlier period, cold lotions to the head, or ice, are 
useful and agreeable. 

The diet must consist strictly of drinks, and nourishing articles 
must be excluded. 

The urine should be drawn off, if not passed every day. 

Inflammation of the membranes of the brain requires a similar 
treatment. 



Acute Hydrocephalus, or Water in the Head. (See Dis- 
eases OF Children.) 

Ophthalmia, or Inflammation of the Eyes. 

This inflammation shows its itself under the forms of catarrhal 
ophthalmia, purulent ophthalmia, strumous ophthalmia, rheumatic 
opthalmia, and gonorrheal opthalmia. 



CATARRHAL OPHTHALMIA. 173 

Of Catarrhal Ophthalmia. 

Symptoms are, redness of the whites of the eyes ; flow of tears ; 
the light causes annoyance; pricking pain, as if some foreign 
body were within the eyelids; eyelids glued together after sleep. 
The redness begins at the circumference, and proceeds gradually 
toward the center; if it pass over the transparent part (the cor- 
nea), the sight will be interfered with, more or less. 

Slight febrile symptoms are the usual accompaniment of this 
state of things. 

Causes are, cold air applied to the part; lime and other for- 
eign bodies getting between the eyelids ; exposure to a strong 
light; wet and cold. 

This catarrhal form is distinguished from the purulent by its 
being milder and non-contagious, from the strumous and rheu- 
matic by signs to be presently detailed. Unless the eyelids have 
become thickened from repeated attacks, this form soon yields to 
proper general and local treatment. 

Treatment. — If there be any catarrh present, we must give 
what is recommended in catarrh, but in many cases local treat- 
ment will alone suffice. Warm fomentations of poppy-heads con- 
stantly applied with gentleness, a purging draught, and light to 
be excluded. As the inflammation diminishes, we should advise 
an eye-water of 

No. 34. Nitrate of silver 1 gr. 

Distilled water 3:ij. or ^ oz. 

Of this solution, drop one drop into the inner angles of the 
eyes about twice a day. 

To prevent the eyelids from being glued together in the morn- 
ing, smear some spermaceti ointment between the eyelids every 
night, or any other simple unirritating ointment. 

If there be any headache or feverishness, leeches or cupping 
at the temples, or at back of the neck, with fever medicines, as 
in Inflammatory Fever. 

Purulent Ophthalmia of Adults. 

This form of ophthalmia occurs also in children. It is severe 
in both adults and children, but in the grown-up person it re- 
q^uires early and decided treatment, or vision may be lost. 



174 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

This is the form of Egyptian ophthalmia. 

There is intense inflammation over the white of the eye, and 
it is accompanied by a great deal of discharge. It sets in much 
in the same way as all inflammation does in the eye, with a sen- 
sation as if sand were there ; then the vessels form rapidly on the 
white part of the eye, which becomes of a bright red, while the 
lids are swollen. 

This form has a tendency to attack the deeper-seated struct- 
ures, and if it does extend so deep, severe pain is felt, with a 
feeling of tension of the whole globe of the eye; the pain is ag- 
gravated at intervals, and is always more severe at night; some 
fever accompanies. 

Causes are, the common causes of inflammation and contagion. 

Treatment. — If the patient has been neglected, or if the dis- 
ease be severe, loss of sight may be expected. Here blood-let- 
ting is imperative, and unto fainting, too. Then a dozen or 
twenty leeches should be applied to the temples, or around the 
orbit, and the bleeding encouraged. 

The eyes should be often sponged, and the matter gently wiped 
ofi". The enlarged vessels on the whites of the eyes, and on the 
inner eyelids, may be scarified with a lancet-point or sharp pen- 
knife, and this often gives great relief. Warm fomentations, or 
cold light bits of linen, may be applied, and the most grateful 
application is to be preferred. 

For the fever signs, saline draughts, and medicines for opening 
the bowels, are needful. 

Diet, to be a decidedly low diet. 

As soon as the redness and heat abate, inject between the eye- 
lids a few drops of this solution every night, or night and morn- 
ing: 

No. 35. Of nitrate of silver 10 grs. 

Distilled water 1 oz. 

To prevent mischief from contagion, the patient must be kept 
alone ; and all towels used by him must not be touched by any 
one else. 

Strumous Ophthalmia 

is a form very frequently to be seen, and very obstinate it is to 
all remedies. It may attack all ages, though it is more fre- 
quently seen in children. 



RHEUMATIC OPHTHALMIA. 175 

The constitutional marks of a scrofulous constitution, will be 
detailed hereafter. 

The signs of this form differ from those of catarrhal oph- 
thalmia, by there being more lachrymation or weeping when 
exposed to the light, by little pustules being sometimes formed 
on the transparent part, and it differs from the purulent fo4^m 
by its minor severity, the absence of the violent pain and of the 
discharge. 

Causes. — Similar to those of other kinds of ophthalmia, acting 
on a scrofulous habit of body. 

Treatment. — The local treatment can be gathered from what 
has preceded — warm fomentations ; but as the local excitement 
is accompanied by a want of power in the vessels, stimulant or 
astringent applications are soon admissible; leeches are seldom 
necessary. Wine of opium may be dropped into the ey^s twice 
a day, or the nitrate of silver lotion. (See Purulent Oph- 
thalmia.) Only the solution must not be so strong as in that 
disease ; five grains to the ounce of water will suffice in the gen- 
erality of cases. 

Blisters behind the ears, if the disease is obstinate ; occasional 
aperients, and quinine pills, one grain in each, to be taken three 
times a day, are recommended, by one good authority, as of ex- 
traordinary efficacy; and the writer also has found them very 
efficacious. 

Rheumatic Ophthalmia. 

This inflammation is attended by violent pain around the orbit, 
extending downward, and even to the ear, and this pain is more 
severe at night; there is a yellowish-red tinge of the whites of 
the eye, and the cornea, or transparent part, may become cloudy. 
The feeling as if there were sand in the eye is not present, and 
the enlarged vessels run in straight lines from the circumference 
of the eye; the tinge is pink rather than bright red; as in the 
catarrhal form, there may attend more or less of fever. Some- 
times, however, the catarrhal and this form are co-existent in the 
same person. 

Treatment. — Bleeding from the arm, or by cupping, or by 
leeches, is necessary in the more acute cases. The bowels are 
to be opened by a salts and senna draught; then these draughts 
ehould be given: . 



176 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

No. 36. Wine of the seeds of colcMcum 20 drops.- 

Bicarbonate of potash -. 20 grs. 

Syrup 1 dr. 

Water 1 oz. 

« 
Three or four times a day. For a night draught, from fifteen 

to thirty drops of tincture of opium should be added. If the 

inflammation continue severe, give 

No. 37. Of Calomel 3 grs. 

Compound ipecacuanha powder, or Do- 
ver's powder 5 grs. 

every night and morning; to be given in thick gruel or mucilage. 

These should be continued till the gums begin to swell, or the 

breath to smell. 

The forehead is to be rubbed every afternoon and evening with 

No. 38. Extract of belladonna.. s;ss. or 30 grs. 

Warm tincture of opium 6 dr. 

Blisters behind the ears. 

Dry warmth to the part; bags filled with hot bran, etc. 
When the symptoms yield, give the tonic infusions, or quinine; 
quinine is to be preferred. 

Gonorrheal Ophthalmia 

is caused by the application of gonorrheal matter. For treat- 
ment, see Purulent Ophthalmia, only we may add twenty 
drops of balsam of copaiba to each saline draught. 

Bleeding, both general and local, is the sheet-anchor in an acute 
rheumatism ; then purging with calomel and compound jalap powder. 

Colchicum is often very useful. So is the iodate of potash, in 
doses of from three to five or ten grains, three times a day, given 
in sweetened water. 

Inflammation of Tongue, or Glossitis. 

This is a rare disease, although it sometimes accompanies in- 
flammation of the larynx or windpipe. It becomes very large 
in some severe cases, and fever of high excitement attends. 

Here no medicines can be swallowed. Blood must be drawn 
from the arm, and leeches applied under and close to the lower 
jaw; but the remedy which seems to have averted suffocation 
sometimes, is scarifying the tongue, or making a tolerable deep 
incision into it. , 



inflamed tonsils, etc. 177 

Inflamed Tonsils, or Tonsillitis, or Cynanche Tonsil- 
laris. 

This disease occurs not unfrequentlj in this climate, and, on 
inspection, we find the tonsils swollen, and the whole circum- 
jacent surface very red and swollen. It begins with chills, ^etc, 
as fever does. Swallowing becomes first difficult, then at last 
impossible. The pain shoots into the ears, a thick ropj mucus 
and saliva are observed in the mouth. The tonsils are so swollen 
in some cases as to meet together. Ulcerations are formed in 
various points. 

Causes. — A scrofulous habit — the usual causes of fever and of 
inflammation. The same persons are often attacked by this dis- 
order. Such persons should avoid standing on wet ground, and 
also cold and humidity. 

Treatment must be vigorous ; blood-letting, according to the 
intensity of the febrile symptoms, and to the powers of the pa- 
tient. The back of the neck may be cupped, or leeches applied 
there, and the tonsils themselves scarified. Active purgation. 

A state of nausea (feeling of sickness) should be kept wp by 
dissolving 

No. 39. Tartar emetic 2 gr. 

Water .• 4 oz. 

and a tea-spoonful of the solution, given every hour, until the 
nausea has been maintained for about twenty-four or thirty hours. 
Then probably the state of excitement and the local swelling will 
have abated. 

In slight cases, the measures need not be so vigorous. After 
a purgative, saline medicines should be given, and poultices ap- 
plied as near as possible to the affected parts. 

A blister to the throat, or back of the neck, is useful after the 
high excitement and inflammation have abated. 

If matter form in the tonsils it will burst, or the collection 
may be opened by the lancet. 

For the Malignant Sore Throat, see Scarlet Fever. 

Mumps. 

This somewhat specific inflammation, mumps, or inflamed pa- 
rotid gland, may occur epidemically, and is capable of being 
propagated by a peculiar contagion. 
12 



178 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Slight febrile symptoms are first observable, then stiffness of 
the jaws, and then a swelling in one or both parotid glands. The 
swelling inci'eases till about the fourth day from the commence- 
ment of the disease, and the gland is swollen firm, and tender to 
the touch; the skin over it does not change color, or else is only 
slightly inflamed. All the movements of the muscles of the jaws 
are very painful, mastication and swallowing any thing are dreaded, 
the attending fever is mild, though nervous irritability and rest- 
lessness attend some cases. 

Soon after the fourth day the swelling begins to decline; then 
the breasts in females, and testicles in men, become swollen and 
hard. There is a gentle sweat on the skin, and the urine shows 
a deposit of red sediment. 

Children and young persons are most liable. 

Treatment. — Avoid cold; keep the parts warm. The bowels 
should be kept open, and perspiration be encouraged by warm 
drinks. 

Inflamed Larynx, or Laryngitis, 

The ordinary precursory symptoms of fever are followed by 
sore throat, hoarseness, and dry, husky cough, coming on by fits 
of coughing. There is pain at the top of the windpipe, increased 
by pressure; constant hawking of a thick mucus; swallowing is 
painful. If the tongue be depressed, we can observe the epiglottis, 
or valve, at the top of the windpipe, red and swelled; hot skin, 
and other signs of fever. Then more serious symptoms set in; 
paleness and anxiety, expansion of nostrils, whispering voice, 
terrible efforts to breath; the pulse becomes small and rapid; 
there is restlessness and anxiety, with a fear of being suffocated. 
Delirium and coma follow on, and death ensues. 

This disease may be fatal in from twelve hours to four or five 
days. 

This is one of the most terrible diseases that assail humanity, 
and the sufferings of the patient, the protracted wheezing of the 
inspiration, the paroxysms of harsh and husky cough, and the 
vain, agonizing attempts to obtain one good full inspiration, are 
painful to behold. 

The Father of his Country is said to have died of this disease. 

Causes are the same as those of common inflammation. There 
seems to be a disposition to a recurrence of the disease, if a 



CATARRH, OR COMMON COLD. 179 

person have once recovered from an attack. Any ulcer about the 
air-pipe may stir up an attack also, under favoring circumstances. 

Treatment. — Whatever is done must be done promptly and 
vigorously; for, although the inflammation is confined to a very 
small surface, yet that surface is situated in a part essential, in- 
dispensable to life. Thus, if hoarseness and pain in the region 
pointed out occur, immediate attention should be paid to them. 
If but for a short time the disease continue unrelieved, the patient 
dies, poisoned by his own impure blood. 

Venesection, the most vigorous that can be borne by the person, 
must be performed, and repeated; then leeches applied close to, 
but not on the part, and a blister to the upper part of the chest. 

For medicines : 

No. 40. Calomel Bijss=50 grs. 

Tartar emetic 1 gr. 

Mix, and divide into sixteen doses. 

Give one every second or third hour, until the swelled gums or 
fetid breath tell us when to stop. 

Blood-letting, however, will perhaps only accelerate death, if 
performed after the full, bounding pulse, the hot skin, and other 
signs of inflammatory fever have given way to signs that show 
the patient's blood is no longer purified, and is overpowering the 
vital powers ; wherefore, a cold skin, a small feeble pulse, blue 
lips, and leaden face, with wavering mind, indicate that the term 
for blood-letting is gone by. What, then, can be done ? 

Why, the air-passage must be opened; an incision or slit must 
be made in it. This sounds like directions for cutting a man's 
throat, yet nothing proves more salutary, when happily successful, 
and the patient may thus be saved, for whom there was previously 
no chance of life. The incision should be made by the surgeon 
in the medium line, an inch or two below Adam's-apple, as the 
projection in man's throat is called. 

Croup, or Cynanche Trachbalis. 

As this disorder attacks children most frequently, see Diseases 
OF Children. 

Catarrh, or Common Cold, 

is an inflammation of the mucous membrane, which lines the air- 



180 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

passages and the interior of the nostrils ; but the complaint differs 
much, according to its site, as to danger. 

When seated in what is called the Schneiderian membrane, 
which lines the nostrils and frontal sinuses, it forms what is called 
cold in the head, and what many call a snivelling cold. 

This is very common in our changeable climate, and its symp- 
toms are familiar to every one. 

Treatment. — This cold may be stopped sometimes at once ; and 
three or four days of annoyance may thus be saved, by taking, 
when going to bed the first night, from fifteen to twenty drops 
of tincture of opium or of laudanum. Some have succeeded in 
cutting short the attack by taking some hot wine negus; perspi- 
ration has followed, and the cold has vanished. When the fever- 
ishness has gone, and the expectoration is thick and loose, we may 
often expedite the cure by a good dinner, and a glass or two of 
wine; but we must be cautious, if the person is of plethoric habit, 
prone to inflammation of the chest, or to consumption. 

The patient should keep in the house, or, if very feverish, in 
bed. He should live upon slops; take James's powder, put his 
feet and legs into hot water, and take an aperient. A better 
preparation than James's powder is, tartar emetic, two grains, and 
water, three ounces. Take of this one tea-spoonful, every two 
hours. 

A dry method of cure has been proposed by Dr. C. Williams, 
which is to act by cutting off the supply of watery materials to 
the blood. The wants of the system take all that can be spared 
from the circulating mass of blood, and nothing is left to feed 
the secretion from the nasal membrane ; in short, the inflammation 
is starved away. 

But to follow up this plan requires great energy and self- 
denial ; for we are so used to our cups at breakfast and tea-time, 
that to have to confine our daily consumption of fluid to one 
table-spoonful of tea or milk, for the morning and evening meals, 
seems a task beyond our powers. The great advantage of this 
plan is that the person may go about and transact business the 
same as usual. 

The best advice that can be given, is to recommend persons 
who frequently sufi"er from these colds, to habituate themselves 
to the cold shower bath, or to sponging with cold water. The 
surface of the body is thus accustomed to a lower temperature 



BRONCHITIS. OR INFLAMMATION OF THE CHEST. 181 

than it is likely to meet with during the day. ' But these baths 
or spongings should be tepid at first, and begun in the summer, 
and the water of gradually-reduced temperature should be used 
until the cold water can be borne. This is the best preventive 
of colds. 

•» 
Bronchitis, or Cold and Inflammation of the Mucous Mem- 
brane OF THE Chest. 

The Suffocative Catarrh of Children, 

This is a threatening and often fatal disorder, especially fatal 
to the extremes of life, to young children and old men. Some- 
times it rages epidemically, and then is called influenza ; but as 
influenza has some features peculiar to itself, it will be described 
separately. Bronchitis is inflammation of the mucous mem- 
brane lining the air cells in the chest. 

Symptoms. — Signs of fever, headache, inflamed eyes, oppres- 
sion at the chest, and impeded respiration ; pains about the chest ; 
expectoration, and the fluid ejected by a cough is a glairy 
mucus, which is transparent, and is so adhesive that if poured 
from one vessel to another, it will draw out like melted glass, and 
the more viscid, the more sticky these sputa are, the greater is the 
existing degree of the inflammation. Some froth is mixed with 
the sputa, and they may be streaked or dotted with blood. But 
after a time the mucus is no longer transparent; it becomes 
mixed with opaque, yellowish, whitish, or even greenish colored 
masses, at first few in number, until the whole of the sputa con- 
sist of them. These denote a giving way of the inflammation, 
the difficulty of breathing and the feverish symptoms diminish, 
and recovery ensues, unless from some cause or other the in- 
flammation is lighted up again. 

When recovery takes place, the favorable change occurs from 
the fourth to the eighth day of the disease. 

The disease may be of acute or chronic nature ; the latter is 
attended with the following symptoms : 

It may follow the acute form, or it may commence as a ca- 
tarrh, or common cold, the signs of which have been described ; 
they return at first every winter ; then they encroach upon the 
warmer seasons, until the patient, mostly middle-aged or old, is 
never free from considerable difficulty of breathing, while more 



182 AMERICAN HOUSEHOLD BOOK OF -MEDICINE. 

or less copious expectoration of various colored masses is con- 
stantly going on. This state has been called humoral, or moist 
asthma, or senile catarrh ; but asthma is a peculiarly marked 
convulsive disease, a disease of the nervous system. In some 
patients, perhaps from co-existent irritation of stomach, a par- 
oxysmal or convulsive state has been superadded to this chronic 
bronchitis, when it closely resembles humid asthma. 

Treat7nent.—B\ood-\ettting from the arm is not required un- 
less the fever symptoms run high. Leeches may be applied to 
the chest; also a blister, but be careful not to put it over the 
leech-bites. 

Saline draughts (No. 3) every four hours, and to each draught 
about the sixteenth of a grain of tartar emetic may be added. 
To do this, dissolve one grain of tartar emetic in two ounces of 
distilled water, and add one drachm of it to each draught. 

Diluent drinks at pleasure; barley water, or barley water gently 
acidulated with syrup of lemons, or one of the drinks hereafter 
to be mentioned. 

But if the hot skin and high fever symptoms, with increasing 
difficulty of breathing, lapse into dark-colored lips, and the ex- 
pectoration continues sticky and tenacious, with difficulty of ejec- 
ting or bringing up, give 

No. 41 Calomel 24 grs. 

Tartar emetic 1 g^^- 

Powdered gum arable 1 dr. 

divided into twelve powders. One every four hours ; but watch 
for redness or swelling of gums, fetid or coppery-tasted breath, 
and stop the powders immediately ; order a myrrh gargle ; and 
if the powders purge, give mixture against diarrhea. (See Di- 
arrhea.) 

These powders save the strength, while they combat the in- 
flammation. The writer has witnessed recovery in many very 
alarming cases when these powders have been so given. When 
convalescent, and as the fever yields, the thirst, etc., give sup- 
porting broths, beef tea ; and if great languor or prostration 
occur, wine and stimulants must be resorted to. 

The chronic form cuts oif many old people, though by slow 
degrees. The treatment must be by expectorants and tonics, 
repeated blisters, mustard poultices, etc. 



INFLUENZA. 183 

No. 42. Of Tpecacuanlia wine 12 to 20 drops. 

Tincture of henbane 20 to 30 drops. 

Syrup 1 drachm. 

Tincture of opium 5 drops. 

Water 1 oz. 

every fourth hour. 

But opium must here be given very cautiously, for it restrains 
the secretions always ; and the expectoration must be encouraged 
and rendered free, or the patient will die; In proportion as the 
lips are livid, the surface cold, and the strength reduced, we 
must be cautious as to opium. 

Influenza 

is a cold, with more or less inflammation of the mucous mem- 
brane lining the air passages of the lungs. It prevails epidemic- 
ally, but is sometimes caught by infection. 

The symptoms are those of cold and subacute bronchitis, 
mixed in varying proportions. The peculiar features are a 
languor and nervous depression, which are very remarkable, 
while there is coldness of the skin, or else cold perspiration. The 
symptoms are those which have already detailed in cold and in 
bronchitis. 

Causes. — Special infection from atmospheric causes, also con- 
tagion. This epidemic has often been preceded by fogs, and 
follows nearly the same route as the Asiatic cholera does. 

Treatment. — Here our treatment is varied, according to the 
prevalent state of excitement or depression. The saline draughts 
and a dose of James's powder every four hours ; but the author 
has found the greatest comfort afforded to patients by adding to 
each draught from fifteen to thirty drops of sal volatile. The 
cold feelings and cold damps on the skin are thus very much re- 
lieved. 

The late Dr. Thomas Davies saved many persons laboring 
under this disorder in its severer form, from mercurializing the 
system, by giving calomel, one, two, or three grains, mixed with 
tartar emetic one-sixteenth of a grain, the strength being sup- 
ported at the same time. This should be borne in mind in 
threatening cases. The author has not alluded to the use of aus- 
cultation by the stethoscope, as he is not addressing medical 
men. 



184 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Pneumonia, or Inflammation of the Lungs. 

The usual precursory and other signs of fever, or pyrexia, as 
it is called, are high fever, hot skin, headache, quick pulse ; and 
the peculiar signs are, pain in the chest, dull rather than acute; 
cough, dry and short; expectoration, scanty; and mucus, which 
is soon tinged with blood, and becomes rusty colored and thick ; 
the breathing quick, from fifteen up to four or five and thirty in 
the minute. 

This disease may decline about the fourth day, or it may con- 
tinue for twelve or fourteen days ; but if the characteristic symp- 
toms increase after the tenth day, and the difficulty of breathing, 
with livid lips and paleness of skin, the event is likely to be un- 
favorable. 

Treatment. — Blood-letting, if it can be done, is the sheet- 
anchor, and it should be repeated two or three times within the 
first thirty hours. 

Leeches in some quantity; a blister; the calomel and tartar 
emetic powders (No, 41,) to be similarly watched as they were 
directed to be; saline draughts and drinks. 

As soon as heat of skin and quick, full pulse subside, with free 
expectoration and greater ease in breathing ensue, a gently-sup- 
porting system is necessary. For a state of prostration, wine 
and expectorants, beef tea, etc. 

Inflammation of the Pleura. 

The pleura is a membrane lining the inside of the ribs, which 
invests also the lungs. 

The usual signs of fever, with a sense of weight about the 
chest. The distinguishing symptom, in conjunction with the 
fever state, is a sharp pain in the side, spreading over more or 
less of the side, front, and even back. This pain is so sharp as 
to induce the sufferer to use the lungs as little as possible in 
breathing, and the breathing is a good deal effected by forced 
action of the muscles covering the bowels; the cough is short 
and dry, and the countenance is anxious; the pain is increased 
by inspiration, and by the cough. 

About the fourth day the pain may be greatly abated, and the 
fever diminish. 



INFLAMMATION OF STOMACH, OR GASTRITIS. 185 

Treatment. — Here, again, the treatment must be active, and 
not a moment is to be lost, or else the inflammation may end 
in the opposing surfaces of the membrane being glued together, 
or by the pouring out of a serous fluid, forming water in the 
chest, or of matter. The system should be put under the influ- 
ence of mercury by the powders No 41. Blood should be tajien 
from the arm, even to fainting, or the blood should be sufi'ered 
to flow until there is relief to the pain and breathing. 

Leeches, from twenty to thirty, to the side afi'ected. 

Saline draughts, drinks, and low diet. 

Inflammation of Stomach, or G-astritis. 

This disease generally is caused by some irritation applied to 
the coats of the stomach. The symptoms are of the usual febrile 
character already detailed; but there is a sharp, fixed, burning 
sort of pain at the pit of the stomach. It is increased by pres- 
sure, by whatever is taken into the stomach, and, in some cases, 
by the movement of respiration. There is frequent vomiting, 
every thing swallowed being instantly rejected. The accom- 
panying fever is of a low type, even though the inflammation 
continues; pulse is small and weak at a very early period. The 
strength is much depressed, skin damp, and features shrunken. 

Life may be destroyed in from twelve to thirty hours, and dur- 
ing the last moments great restlessness, anxiety, hiccup, and drum- 
like distension of the skin at or about the pit of the stomach. 

Causes. — Acrid or poisonous substances taken into the stom- 
ach; drinking cold liquids when the body is heated, and in a 
state of exhaustion. 

Treatment. — Notwithstanding the seemingly small, feeble pulse, 
venesection must be performed; the pulse will rise, or appear to 
beat fuller, as the inflammation is relieved. Then apply leeches 
over the pit of the stomach, and encourage the bleeding. 

Ice, or iced water, in small quantities, to be swallowed 

Keep the bowels open by clysters of warm water; or, if the 
bowels are confined, with clysters of warm water with Epsom 
salts, half an ounce dissolved in each. 

Injections of starch or gruel, four ounces, and thirty or forty 
drops of tincture of opium, may check the vomiting; so will one 
drop of hydrocyanic acid, in about three tea-spoonfuls of water. 



186 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Gruel, linseed tea, barley- water, etc., for drinks, in very small 
quantities at a time. 

There is a subacute gastritis which will be noticed under Indi- 
gestion. 

Inflammation of Bowels, ok Enteritis. 

This may begin with signs like those of colic, but very soon 
those of fever set in; furred skin, thirst, etc. The characteris- 
tics are acute pain, increased by pressure, which mostly relieves 
colic pain, nor does the pain relax or intermit, as in colic; the 
pain, too, is increased by any movements of the abdominal (belly) 
muscles, wherefore the knees are drawn up to relax those muscles. 
We have seen, in pleurisy, that the patient breathes by the ab- 
dominal muscles, and the ribs are as motionless as possible. 
Here the breathing is by the chest muscles as much as possible ; 
in colic, the mode of breathing is not altered, and the patient 
tosses and turns about, whereas in enteritis he lies as quiet as 
possible. 

There are nausea and vomiting to a distressing degree, both 
when any thing is admitted into the stomach and when the 
stomach is empty; costiveness. 

If the pulse at the outset is full and strong, it soon becomes 
small, and like a wire under the finger ; it intermits ; the features 
seem to shrink; the legs grow cold, hiccup comes on, and drum- 
like belly; the pain relaxes, but cold sweats break out, and death 
soon terminates all suffering. 

Treatment. — Notwithstanding the small pulse, bleed and leech. 
As all liquid medicines will increase the vomiting, give no 
draughts, but 

No. 43. Of Calomel 5 grs. 

Powdered opium 1 gr. 

every hour until five grains of opium shall be taken, and then 
repeat the dose every four hours, watching the effect. 

We must try to remove costiveness by lavements of warm 
water, and not to give any aperients by the mouth until the 
acute stage has passed away. 

If we see a case where the small weak pulse is accompanied 
by drum-like distension of belly, by coldness of skin, etc., we 
must not bleed, nor lower the powers at all. 



INFLAMMATION OF THE KIDNEY. 187 



Inflammation of the Peritoneum. 

The peritonaeum is a membrane lining the interior of the mus- 
cles over the abdomen, or bellj ; but the symptoms ai;id treatment 
are nearly the same as those of enteritis. 

Inflammation of the Kidney. 

With the usual febrile signs, there is pain in the back cor- 
responding to the region of the kidney, shooting down to the 
groin; the testicle is sometimes drawn upward; the pain is deep- 
seated, dull, increased by firm pressure, by the erect or sitting 
posture, and sometimes by coughing or sneezing. The sufferer 
lies on the affected side, with the corresponding limb drawn up 
to the affected side; nausea and vomiting, and frequent calls to 
make water, which at first may be bloody and high-colored, then 
becomes pale; bowels are confined; an anxious countenance; 
spirits depressed. 

This disorder must be distinguished from lumbago and colic; 
but in lumbago the pain is on both sides, and does not shoot 
down to groin; neither are there nausea and vomiting, while in 
colic the urine is not disturbed. 

Treatment. — ^Venesection, leeches, and fomentations to the 
back; no blisters. 

Purgatives of castor-oil are best; lavements of warm water 
are often of great service. 

Barley-water with gum arable in it. Diluting liquids. 

Inflammation of Liver. 

Much more frequent in warm climates than in cold. The signs 
are those of fever — pain and a feeling of tension on the right 
side, over the liver region; this pain may be dull or sharp, and 
pricking, according to the part of the liver which is affected, and 
it shoots, in some cases, up to the right shoulder and parts ad- 
jacent; but sometimes to the left shoulder, when the left lobe of 
the liver is affected. The movements during the breathing in- 
crease this pain, and the patient can not lie on the left side 
usually. With all these, nausea and vomiting may arise if the 
part of the liver near the stomach is inflamed. This pain in the 



188 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

shoulder has frequently been mistaken for rheumatism. Jaundice 
may attend, but not always. 

Treatment. — The object is to reduce the inflammation before 
it terminates in>j;he formation of matter, which matter may become 
dangerous to life. Blood-letting and leeching, as in the forego- 
ing diseases, only we need not bleed from the arm, after four or 
five days have elapsed. 

Repeated blisters. 

Purges of infusion and salts, as in No. 2. 

Lavements are useful, and after the high inflammatory signs 
have decreased, the calomel and antimony powders (No. 32), low 
diet. 

Chronic Hepatitis, oe Liver Disease, 

This may follow an acute attack, or it may arise independently. 
The symptoms are rather obscure ; there may be thirst, and other 
signs of feverishness, or none may be perceptible. The diges- 
tion becomes disturbed some three hours after a meal, the bowels 
usually confined, and the motions lumpy, and clay or ash-colored. 
There may be more or less of jaundice, and a feeling of tension 
or weight in the right hepatic region may attract attention. 
Pains may exist, but they are not usual. If an abscess have 
formed, or is forming in the liver, shiverings, or what are tech- 
nically called rigors, give tokens. 

This disease may prove fatal by inducing dropsy. 

Treatment. — Leeching for local pain is sometimes required. 

If the bowels are not in an irritable state, purgation is most 
efficacious. 

No. 44. Blue pill 3 grs. 

Compound extract of colocynth. 2 grs. 

Make a pill, to be taken every night for four or five nights, 
and next morning give the salts and senna mixture, so as to se- 
cure a tolerably free action of the bowels, so far as the patient 
can bear. Mercury has been forbidden in this complaint; but 
so long as the stools are light and clay-colored, the mercury is 
likely to do good. 

Bitter tonics, such as taraxacum, gentian, etc., with soda. 
The dandelion or taraxacum is useful when light-colored stools 
proclaim a torpor of the liver, and when the stomach functions 
are not impaired. 



INFLAMMATION OF THE BLADDER. ■< 189 

No. 45. Bruised dandelion 4 oz. 

Distilled water li pints. 

Boil down to a pint and strain. 

No. 46. Of this decoction 2 oz. 

Carbonate of soda 5^8. 

Compound tincture of gentian 1 dr. 

Give three times a day 

Either of the other bitter infusions, with soda, may be given in 
like manner. 

One of the most efficacious remedies, both internally or ex- 
ternally, is the nitro-muriatic acid. 

No. 47. Of Muriatic acid 1 dr. 

Nitric acid, diluted J- dr. 

Compound infusion of orange peel, or of 

gentian 6 oz. 

Mix. 

Dose, two table-spoonfuls thrice daily. 
The Nitro-muriatic acid lotion : 

No. 48. Muriatic acid 3 oz. 

Nitric 2 oz. 

Water 5 oz. 

Mix. 

Two table-spoonfuls of this to a quart of water may be ap- 
plied warm, over the right side, several times a day. If a bath 
of this sort can be obtained, it would, probably, be very useful. 
(For treatment of bilious headache, and the ordinary bilious dis- 
orders, see first section, article. Secretions.) Change of scene, 
and from a hot climate to a colder one, are necessary. Certain 
mineral waters may be resorted to. (See Mineral Waters.) 



Inflammation of the Bladder — Cystitis. 

Acute and chronic; symptoms, feverishness ; the local or pe- 
culiar signs are sharp pain in the region of the bladder, in- 
creased upon pressure at the lower part of the belly ; frequent 
making of water, with painful discharge of urine. There may be 
a bearing down, and also vomiting may attend. 

Treatment. — ^Blood-letting or leeches, according to violence of 
symptoms of fever ; warm fomentations, absolute rest, warm 
bath; Dover's powder, and potash or soda. 



190 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

No. 49. Dover's powder 4 grs. 

Bicarbonate of potash or of soda 20 grs. 

Syrup 1 dr. 

Water 1 oz. 

Every fourth hour. The bowels are to be kept open by castor- 
oil, and by lavements of a soothing, emolient character. The 
chronic form is shown by pain or uneasiness on making water, 
and by mucus appearing in the urine. In the latter periods of 
this chronic form, we may be obliged to give copaiba capsules 
with soda draughts, as in No. 49, keeping the bowels open by 
castor-oil. 

In both forms the urine should be rendered as unirritating as 
possible, by tumblerfuls frequently of barley or gum-water, etc. 



Inflammation of the Urethra, or Urethritis. 

The male urethra is a somewhat tortuous canal, with very- 
delicate irritable lining membrane ; and when seized with in- 
flammatory actions, much pain, and even agony, results. There 
is a pain deep-seated in the perineeum, and often sharp pain in 
passing the water, with spasm that temporarily arrests the flow. 
There may be a white mucus cloud in the urine, with scanti- 
ness of it, and after a while pus or matter is ejected. More or 
less of fever may be present. 

This disease may arise from exposure to a draught of cold air 
of the part (the perinaeum) in a sweating state, while the con- 
stitution is not in a healthy condition. 

Treatment. — Leeches, according to severity of symptoms, must 
be applied to the perinseum, the bleeding encouraged by fomen- 
tations or poultices. Drink freely of diluents, barley-water, etc. ; 
get the bowels open, and give these draughts: 

No. 50. Bicarbonate of potash 9j. 

Syrup 5j. 

Water 1 oz. 

Tincture of henbane 20 to 30 drops. 

About three times a day. Low diet. 

If a purulent discharge continue when all other signs have 
disappeared, balsam of copaiba capsules or cubebs may be tried. 
Much caution as to eatables and drinkables will be requisite, for, 
jt may be, years afterward, to prevent sujffering or a relapse. 



rheumatism— rheumatic fever. 191 

Rheumatism 

is inflammation of a peculiar or specific kind, and differs from 
common inflammation in never terminating in suppuration nor 
gangrene. 

It may be acute or chronic, the acute forming an attack ^f 
what is called rheumatic fever. 

Rheumatic Fever. 

This attacks the tendons and ligaments. It seems, at times, 
confined to certain joints; it is then called synovial rheumatism. 
The other species is called fibrous rheumatism. The attending 
fever is of the inflammatory character; tongue covered with thick 
white buffy coat; skin moist, and sometimes drenched with sour 
perspirations, so sour as to attract strong attention; pulse, full, 
round, and bounding; urine, high-colored, with, after a time, a 
rose-colored sediment. The chief sign is pain, which is very 
sharp, increased on every movement and affecting different parts, 
and shifting about, leaving a redness and swelling behind it. The 
synovial kind affects some joints, more frequently the knees ; the 
patient lies on his back, utterly without motion, for every bend- 
ing of the joint gives pain, even amounting to agony. Thirst, 
joints swollen, smooth, and of pale-red color. 

Causes. — In acute rheumatism, the blood contains some irrita- 
ting or poisonous ingredient, which falls upon particular parts of 
fibrous structure; cold and damp, obstructed perspiration, getting 
cold on issuing from heated rooms, etc. 

Treatment. — Rheumatism is not in itself dangerous to life ; but 
the valves of the heart, or other parts of the heart, or the peri- 
cardium (that is, the bag containing the heart) may become im- 
plicated, and then great danger to life immediately ensues. And 
even if" life be saved, without the heart affection having been 
thoroughly subdued, the patient will have to live an invalid's Hfe 
ever after. 

When the heart is attacked during rheumatic fever, there will 
be sudden pain over the region of the heart; considerable diffi- 
culty of breathing, and increased impulse of the heart's beat; 
while, in some cases, the countenance becomes very anxious. 

If the fever signs run high, blood-letting. In this disease it 



192 AMERICAN HOUSEHOLD BOOK OF- MEDICINE. 

is the great remedy, and should be pushed to as great an extent 
as the patient can bear; when the heart is involved, thirty or 
forty leeches should be applied over it. But few cases, however, 
will require this, though in almost all some leeches will be useful. 
The bowels should be opened gently, 8.nd then a night-pill given: 

No. 51. Blue pill 4 gr. 

Dover's powder, commonly called com- 
pound ipecacuanha powder 6 gr. 

To be made into two or three pills, and taken every night for 
six or eight nights. 

Then the following draught : 

No. 52. Bicarbonate of potash J dr. or 30 gr. 

Wine of seeds of meadow saffron, 

called colehicum 20 drops. 

Syrup 1 dr. 

Water 1 oz. 

Every four hours, until the pain gives way, or until a feeling 
of nausea comes on, which would become vomiting; or, until the 
bowels become very loose; or, until drenching sweats (not the 
sour peculiar sweats of rheumatic fever) appear; then the col- 
ehicum must be immediately discontinued. 

The writer has seen the greatest advantages derived from these 
draughts, nor has he ever seen any harm accrue from the use 
of the colehicum, so long as the above-stated precautions are 
observed. The potash in these draughts seems to help to arrest 
the sour sweats, and, during twenty years' use of them, he has 
never met with one instance of translation of disease to the heart 
during rheumatic fever. 

If pain distress very much, fifteen or twenty drops of tincture 
of opium should be added to each draught. 

The affection of the heart which supervenes, or is coincident, 
requires most vigorous treatment, as to blood-letting; and the 
system ought to be put under the influence of mercury as soon 
as possible, by the calomel and antimony powders. No. 32 ; but 
these are cases requiring professional attendance, if it can be 
procured. 

The affected joints may be kept cool with Goulard water, or 
with Eau de Cologne lotion; and if pain remain after the heat 
and redness have subsided, gently rub, night and morning, this 
liniment over the affected parts; and it often gives great relief: 



CHRONIC RHEUMATISM— GOUT. 193 

No. 53. Soap liniment 8 oz. 

Extract of belladonna 1 dr. 

Cyanuret of potash 20 gr. 

As the state of excitement passes away, give the bitter infu- 
sions, with nourishment, etc. (See Fever.) 

Chronic Rheumatism. 

The forms of this are rheumatic headache, pain in the side, 
lumbago, or pain in the small of the back, and sciatica. 

These pains are often sharp, and will come on in fits or par- 
oxysms every day or alternate day, not unlike to ague, in this 
respect, of their periodical visitation. There are no marked con- 
stitutional symptoms. The headache pain may be situated in 
any part of the head, but it is more frequently met with on the 
top of the head. The pain is relieved somewhat by pressure. 

In all these forms the draught No. 53, may be given, and the 
liniment No. 54, rubbed in ; but, between the attacks of pain, 
sulphate of quinine should be given, one or two grains, in form of 
a pill, two or three times a day, during the intervals of freedom 
from pain. If fullness of the head or giddiness ensue, or a buzz- 
ing in the ear, the quinine must be discontinued. For the rheu- 
matic headaches the hydriodate of potash has been found useful, 
about three to five grains in some tonic infusion. (See Fever.) 
But any dryness of the mouth, or pain in the stomach, will tell 
us when this remedy is disagreeing, and when its use must be 
stopped. 

In rheumatic stitch in the side, points de cote of the French, 
poultices, on which some powdered opium has been sprinkled, 
have often given relief; or the plaster of belladonna may be ap- 
plied, or the liniment No. 54 rubbed in. 

Wet and cold must be avoided; flannel, warm; and to wear as 
much silk covering as possible i^ advisable, to guard against the 
electrical changes in the atmosphere. 

Several mineral waters are famed for alleviating rheumatic 
attacks. 

Gout. 

An attack of gout is generally preceded by signs of stomach 
ailment; of indigestion; then, generally about one or two in the 
morning, a violent pain seizes on the great toe, or some other 
13 



194 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

joint. The violent pain continues a certain time — till next niglit — - 
when, after sweating and sleep, the joint swells, becomes of a deep 
red color, the skin is distended, and there is swelling, more or 
less, in the parts circumjacent. 

This round of symptoms will go on for several days, when the 
swelling and redness subside; the skin peels off, and the part is 
as it was before the attack; or, after many attacks, chalk-stones 
form in it. 

When there is not sufficient energy in the system to allow of 
a regular fit of the gout, the disease may attack the head, when 
a state resembling apoplexy ensues, or else headache and other 
head symptoms arise. When the stomach suffers, there are pains 
in the gastric region, nausea, vomiting ; when the heart, there 
will be palpitations, and tendency to fainting. 

Causes are hereditary predisposition, fullness of body, middle 
age, a sedentary life and luxurious habits, acid wines, and errors 
in diet. 

Treatment. — When time is of consequence, and speedy recovery 
sought, sharp and continued purgation is requisite; and the mor- 
bific element is thus got rid of. The best plan is to give an 
aperient pill, and draught next morning; then the draughts re- 
commended in rheumatism, to which twenty grains of acetate of 
potash may be added. 

To quiet the pains, some twenty drops of tincture of opium, 
at night, or ten grains of Dover's powder. 

To the part, poultices, with powdered opium sprinkled on them; 
but cold applications may be dangerous. 

When the stomach suffers, give stimulants — warm brandy and 
water, ether, ammonia and camphor, and the bicarbonate of potash. 
For prevention of attacks, diet during convalescence and the inter- 
vals, see Diet. 

Dysentery, or Inflammation of the Colon. 

Fever, with, at first, costiveness and flatulence; griping pains, 
then discharges of offensive, variously-colored motions, with se- 
vere bearing-down pain ; masses of hardened, feculent matter are 
passed, of a globular form. These stools form the marking char- 
acter; the pulse is quick and weak, and a sense of local heat, 
with hiccup and great prostration, follows. 



ERYSIPELAS. 195 

Causes. — A peculiar contagion, fatigue, bad diet, intemperance, 
exposure to miasms. 

Treatment. — If the fever is not attended with great debility and 
prostration, apply leeches and warm fomentations ; or, better still, 
warm baths. Then the salts and senna draught. 

Then Dover's powder ten grains, with two grains of the gray 
powder (mercury and chalk), three or four times a day, and 
encourage perspiration by warm drinks. 

To relieve the bearing down, a lavement of two ounces of starch 
decoction, with thirty drops of tincture of opium ; or, if the lower 
bowel is very sore, and will not bear the introduction of the 
clyster-pipe, then a grain of opium, mixed with a small bit of 
soap, may be introduced into the bowel. If the fever is of typhus 
character, ammonia in camphor-mixture, and stimulants. 

To prevent relapses, flannel round the belly must be worn, and 
care taken to avoid the causes. 



Eruptive Fevers. 

Erysipelas. 

This is an inflammation of the skin, both contagious and in- 
fectious. The attack may occur in from two to fourteen days 
after exposure to the cause. It does not, like small-pox, secure 
from a second attack; and it may coexist with fever, and with 
other diseases. It may be mild or severe, or it may terminate 
in forming matter, or in gangrene. The fever has been divided 
into three stages; the first, inflammatory (see Inflammatory 
Fever) ; in about five or six days, the second commences, with 
brown fur on the tongue, when typhus symptoms appear; matter 
may form when the head is aifected, and this kind of erysipelas is 
very dangerous; it may accompany wounds and external injuries. 

Treatment must be modified according to the strength, and to 
the inflammatory symptoms. Aperients and salines, as in fever; 
but tonics, that is, quinine, may be given early; indeed, some begin 
with the bark. Looseness of bowels, and all exhausting discharges 
must be stopped; for looseness, see Diarrhea; for sweats, the mix- 
ture No. 56, with wine. The quinine should be given in large 
doses, three or four or six grains, every four hours ; when buzzing 
in the ears occur, discontinue the quinine, continuing the wine. 



196 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

For local applications, warm fomentations, flannels wrung out 
of hot water, constantly renewed, so long as such applications 
are grateful and soothing to the patient. When no longer so, 
try cold — cold water cloths, renewed as they become hot; some 
recommend flour to be dredged over the parts, and it often 
proves very pleasant to the sufferer. 

A minor degree of erysipelas sometimes is seen without fever, 
only more redness, with an itching of the skin, which is not 
swollen. This is called erythema ; and it is often of importance 
not to meddle with it incautiously, as it is a sort of safety-valve 
in elderly persons, and in certain habits of body. 

The writer recollects one case in point, where the gentleman, 
between sixty and seventy years of age, complained of an in- 
flammation of the legs of this kind, and especially of the itching, 
which prevented sleep for hours. He wished to have the in- 
flammation removed as soon as possible. The writer refused to 
undertake the case, unless he would undergo preliminary con- 
stitutional treatment by aperients, and a more rigid diet than 
the patient liked to submit to. The itching was removed, but 
local astringents were refused. The habit of body was pletho- 
ric. After the writer left the place, this poor but obstinate 
gentleman, notwithstanding he had been told of probable conse- 
quences, put himself under a French druggist, who soon re- 
moved the redness. In a short time afterward he was seized 
with apoplexy, which proved fatal, almost before the medical 
man, who had been summoned from a distance, could arrive. 

Thus, similar inflammations may appear slight, but they may 
be so connected with the constitution as to be clearing it of 
some internal irritation, and preventing an attack dangerous to 
life. 

To such cases constitutional treatment is alone safe, and only 
the mildest local applications should be resorted to; putting the 
secretions in order by aperients, and regulating the diet, insist- 
ing upon air and exercise, and the avoidance of sedentary habits. 

Small Pox 

may be distinct, where the pocks are distinct from each other; 
or confluent, where they run together. 

To pains in back and loins, the usual fever symptoms succeed; 



SMALL POX. 197 

and in three days, small red points appear on tlie face and head, 
the tongue i.s usually heavily loaded with a thick yellow or 
brownish coat, and much headache is present. By the fifth day 
(the second after the eruption) a little Tesicle, with some color- 
less fluid in it, appears on each point, and an inflamed margin 
extends around. On the sixth day the fever lessens, and a 'n^is- 
cid saliva in the mouth is troublesome ; and, on inspection, 
the throat is swelled, with, perhaps, spots of eruption ; swallowing 
is painful, the face and head swell, sometimes to a great size. 
About the eleventh day the spots are of full size, about that of 
a pea, usually ; the swelling of face subsides^ and the hands and 
feet swell ; a crust forms on each pustule ; feverish symptoms 
again appear, forming the secondary fever. The crusts dry and 
fall ofi", leaving spots of brownish color ; these last either disap- 
pear in time, or indentations are left on the skin. On the first 
and second day the eruption is like solid red spots, papular, as 
it is called ; on the third, fourth, and fifth, there is some light- 
colored fluid in each pock ; the sixth and seventh, the fluid 
changes ; on the eighth day it is yellow (pus) ; ninth, tenth, elev- 
enth, twelfth, and thirteenth, each pock goes through various 
stages, until they burst, and scabs are formed. 

The confluent sort is very dangerous — the fever being typhus, 
with prostration of the powers ; coma, and delirium. The spots 
run together, are not circular, and the skin between them is of 
a dusky red. The first fever never remits, and symptoms of 
putrescency soon appear. Inflammation of the eyes is an occa- 
sional accompaniment ; and diarrhea, or bleeding at the nose, is 
not unusual in either of the forms. 

Causes. — Special contagion or inoculation. The attack of this 
disease takes place in from ten to sixteen days after exposure 
to the cause. 

Treatmefit. — When the fever is violent, we must try to mod- 
erate it; the strength must be supported, and violent symptoms 
or inflammation combated. The aperient pills and Epsom salts 
mixture should first be given, and saline draught, with low diet, 
and a free ventilation of the apartment, are necessary afterward ; 
but, as soon as the strength fails, or the pocks become flattened, 
some ammonia mixture with nourishment — beef tea, mutton-broth, 
etc., and wine, or brandy and water. 



198 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

No. 54. Carbonate of ammonia 40 gr. 

Camphor mixture 6^ oz. 

Syrup J oz. 

Liquor of acetate of ammonia ^j. 

An eighth part every four hours, 

If the bowels are purged, see Diarrhea. If sweats exhaust — 

No. 55. Dilute sulphuric acid , 1 drachm. 

Syrup ^ oz. 

Infusion of calumba -^ oz. 

A sixth part every four hours. 

Light and air give vigor to arterial action. Hencej in parts 
exposed to the air, the pock-marks are deepest, as in the face, 
neck, etc. ; and most deformity ensues where it is most annoying. 
To prevent these marks, the writer has derived great benefit 
from sprinkling over the face, or over each pock in the face and 
neck, some prepared calamine, (impure oxide or carbonate of 
zinc,) in fine powder; he thinks the usually-dreaded secondary 
fever has thus been rendered milder and less fatal. This should 
be done on the fifth day; and several persons have been thus 
saved from deep and disfiguring marks. 

In convalescence, the gentle tonic infusion and nourishing diet. 

Cow Pox. (See Diseases of Children.) 

Cox Pow, or Inoculation, will be mentioned in the section de- 
voted to Diseases of Children. 

Scarlatina, or Scarlet Fever. 

The danger from this disease varies; and sometimes it is so 
mild that little or nothing need be done as to remedies; nature 
alone will be all-sufiicient. But there are cases than which none 
are more deadly, not even the plague itself. 

After the usual symptoms denoting the approach of fever — 
viz., chills of surface, nausea, pains in head and back, thirst, 
heat, restlessness, and frequent pulse — set in, the first stage, that 
is, from the commencement of the eruption, varies in duration 
from twenty-four to seventy-two hours ; the second stage, or that 
extending from appearance of eruption to its subsidence, from 
six to eight days; and the third, or that from appearance of the 
eruption till its disappearance, from a few hours to two or three 



SCARLATIXA, OH SCARLET FEVER. 199 

weekSc So the whole course may extend from eight to thirty 
days. 

The poison of this disease acts either on the skin, or the mu- 
cous membrane of the mouth and throat; and it may be limited 
to one or the other, or it may attack both. The poison of measles 
acts on the mucous membrane, lining the air-tubes below Adam.'s- 
apple, or the projection in the throat; while that of scarlatina 
affects the mouth and upper gullet above that point. Measles 
are of inflammatory character, scarlatina of typhoid. This dis- 
ease is divided into a mild form, a severe form, and a putrid form. 

When the fever symptoms have lasted about two days, a great 
many red points, separated by portions of skin of the natural 
color, first appear over the face and neck; whence it extendi 
over the body. The interstices between the points become red 
from their coalescing. 

In a couple of days, the eruption separates into patches, the- 
skin is perceptibly rough to the touch, and scurf forms on the 
skin. Sometimes the scurf-skin has peeled off from the handsy 
preserving the shape of the fingers like a glove; and one author 
(Dr. Frank) alludes to having seen the warts on the fingers thrown 
off in the scurf. The rash begins to decline on the fifth day, and 
wholly disappears by the eighth. On looking into the mouth and 
throat, we shall see a bright red color extending over the whole- 
of the surface which is visible. The tongue is remarkable, for 
through its white fur may be seen some protruding red points 
(the papillae, which are unusually long) ; but, in some cases, the 
tongue is red all over its extent. 

Some simple and very mild cases may consist of mere redness 
of the skin, without any affection of the throat; but, usually, the 
tonsils and glands under the tongue and lower jaw are swollen, 
and the act of swallowing causes pain, extending to the ear. The 
inflammation has sometimes crept up the passage to the ear from 
the upper and back part of the mouth, causing deafness. 

In the malignant form, the mouth and tonsils are less swollen 
than in the preceding kinds, but the color is deeper, the redness 
being of a more intense red or livid color. In the former degree, 
little specks of white lymph may have been deposited on the 
throat and tonsils ; which specks or spots, if washed or wiped 
away, will leave the red skin underneath, in the milder species-; 
but in the severe and malignant form, there is ulceration beneath 



200 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

tliem ; tnat is. ulcers, more or less deep, are formed in twenty- 
four or thirty hours, by the sloughing away of the mucous mem- 
brane. Fluids are rejected through the nostrils. The tongue, 
friOm the first, is covered with a brownish fur, more or less dark 
colored. The initiatory symptoms are those of typhus fever; 
vomiting and diarrhea are frequent; headache, pain in the back, 
oppression at the pit of the stomach ; eyes heavy and muddy ; 
pulse small and fluttering, great nervous depression; the breath 
is fetid, and ash-colored spots are visible over the interior of the 
raouth and throat. Ulceration and gangrene follow; the voice 
becomes hoarse, and the breathing is attended with a noise as 
of one strangling; fierce delirium, with hiccup, bloody stools, 
etc., close the scene of the awful malady. 

Danger may arise from the poison of scarlatina causing dropsy, 
which dropsy supervenes rather on the milder than on the se- 
vere forms of this disease. It begins with edema, or swelling 
of the face, which afi'ects other parts of the body. The urine 
is scanty at first, but soon becomes copious ; the pulse is quick, 
and no more serious form of dropsy may show itself; but the 
serum may be effused into the head, when headache, convul- 
sions, etc., give evidence of the danger. It may be effused 
into the chest, when difficulty of. breathing will become mani- 
fest ; or the poison may attack the kidneys, giving rise to renal 
or kidney dropsy. Wherever the poison has been freely elimi- 
nated by the skin, dropsy is seldom if ever seen ; therefore, it 
does not follow cases of great severity, or those accompanied 
with much eruption. Dropsy appears between the sixteenth and 
twenty-fifth day ; and if no dropsy appeared by the end of the 
fourth week. Dr. Wells considered all danger of its occurring 
had passed over. It usually appears about the twenty-first day 
from the commencement of the fever. Dropsy may attack the 
cellular membrane of the body and limbs, without affecting any 
of the interior organs. One attack secures the sufferer from a 
second one. 

Causes. — Specific contagion. The latent period is from two to 
ten days after exposure to the cause. 

Treatment. — In the mild form, a temperature of about 60° of 
Fahrenheit's scale should be kept up. Pure air, no animal food, 
gentle aperients, diluting drinks. The attack soon passes off. 

But in proportion as the fever assumes the typhus form, and 



SCARLATINA, OR SCARLET FEVER. 201 

the throat symptoms put on the character above described, we 
must support the strength, and enable the patient to survive the 
prostration caused bv the scarlatinal poison ; wherefore, the qui- 
nine mixture, with acid No. 21, must be given assiduously; and 
wine, also, at regular intervals, with sago. But since children 
can hardly be made to take the bitter quinine, we must ^ely 
chiefly on wine. 

An observant person can easily see whether these remedies 
are doing good by their effects, or whether they are given in too 
large quantities. The treatment recommended in typhus will be 
proper here. 

Sometimes the eruption fades suddenly, and distressing op- 
pression and inward symptoms follow, with death, if not relieved 
by a return of the eruption. Dr. A. T. Thompson recovered 
some cases of this kind, by immersing the patients in a bath, 
with flour of mustard thrown into it. The skin, in one case, be- 
came red as a lobster; but all inward suffering and danger to 
life ceased forthwith. 

Some medical men strongly recommend the carbonate of am- 
monia, 5 grains in decoction of bark, 1 or If oz., every three or 
four hours. Others give chlorine, in the form of chlorate of 
potash. 

No. 56. Chlorate of potash 3 to 5 grains. 

Muriatic or hydrochloric acid .... 10 to 12 drops. 
Infusion of bark 1 oz. 

Or else, if the bark is too disagreeable, 

No. 57. Syrup of orange-peel 1 or IJ- dr. 

Water, or barley-water 1 or 2 oz. 

instead of the infusion of bark, every three or four hours. 

• As to local applications to the throat, the writer has painted, 
by means of a camel-hair brush, over the whole surface of throat 
and tonsils, every night and morning, with this solution of iodine. 

No. 58. Spirits of wine 2 oz. 

Purified iodine 40 grs. . 

This should be continued to be applied, even when gangrene 
and deep ulcerations exist; but if the unprofessional reader can 
not do this, though it is not difficult to do, the following gargle 
should be often used ; or, if the gargle can not be used, the parts 
should be washed with it, for it is of importance to keep the 



202 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

surface of the throat as clean and as clear from putrescent matter 
as possible. Such matter reacts upon and depresses the consti- 
tution. 

Scarlatina^ or anti -putrescent Garble. 

No. 59. Hydrochloric acid 1 dr. 

Honey, or honey of roses ; 1 oz. 

Tincture of myrrh ^ oz. 

Barley-water 7 oz^ 

Mix for a gargle. 

But as depression and exhaustion pi*evail, press the wine or 
brandy and water, with animal jelly or beef tea, between the 
hours of taking the stimulus. The patient must be supported 
against the sedative effect of the poison, and it may encourage 
the timid and despairing if the author mention one of his cases 
in a lad of fifteen, where the throat was in such a state that milk 
and wine had to be poured into the gullet by the quill of a pen. 
Life was thus supported for ten days, and recovery ensued. 

As to preventing an attack of scarlatina, in those who are ex- 
posed to danger, and have never previously suffered, he has never 
seen any evidence of good from administering, with this view, the 
belladonna, as recommended by Dr. Hahnemann; but if any one 
should wish to try it — and it may do some good by giving confi- 
dence — Dr. Hahnemann's preventive is this : 

No. 60. Extract of belladonna 3 grs. 

Distilled water 1 oz. 

Of this, give three drops, twice a day, to a child under twelve 
months, and add one drop more for every year of the age be- 
yond that of the first year. He says, if taken five days beforie 
the infection, if it do not prevent, it will render the attack milder. 

NoWj if we are asked, when does the danger cease of giving 
or catching this disease? we must say, we do not know; but so 
long as the scarfskin is being cast off in the shape of scales, etc., 
there is danger of infection. 

Of course, all offensive excretions must be removed constantly 
from the bed-room; and cloths, wetted with chloride of soda or 
lime solution, should be hanging about the room. 

The clothes of the patient, of the bed, and even the walls them- 
selves, retain and obstinately hold the power of infection for 
months after the case has terminated, and white or limewashing, 
fumigations, or even shutting up the room, and burning sulphur, 



PLAGUE, OR PESTIS. 203 

have not eradicated all danger. Still these precautions must be 
taken. As to clothes, the author has found that exposing them 
to a great degree of heat has seemed to prevent infection. They 
should be put into an oven, and exposed to -a heat of 220° Fah- 
renheit for some hours. There is some reason to think that the 
lieat decomposes the lurking poison — volatilizes it, it may be &aid. 
This precaution, then, should never be neglected. Dr. Henry, 
of Manchester, England, recommended this in 1832, and it has 
been found effectual in Egypt. Bales of goods have been thus 
disinfected. The air in the interstices of such bales retains the 
poison usually. 

For the treatment of dropsy, see Dropsy. 

Plague, or Pestis. 

This is a malignant or putrid typhus fever, with certain gland- 
ular swellings in the arm or groins called buboes, carbuncles, or 
pustules, of a white, livid, or black color. 

The stages vary; there are no premonitory signs, and so in- 
tensely deadly is the poison in some cases, that life is very soon 
extinguished. 

The symptoms of a severe attack are those of the worst kind 
of typhus, but the fever is more intense in plague. The gait 
staggering, and the eruption of buboes, etc., mark the nature of 
the disease. 

The symptoms need not be detailed to those who have read 
the signs of typhus, only the anxiety and nervous dread are 
greater, while utter prostration attends throughout, almost from 
the beginning. 

An occasional darting pain in the region of the gland precedes 
the formation of a plague bubo, when, some hours after, a deep- 
ly-seated, hard, round tumor, moveable and painful on pressure, 
shows itself; the skin does not inflame until the bubo has con- 
tinued eight or nine days, when it becomes discolored. On the 
fourteenth or twenty-second day, if life be spared so long, matter 
forms, which is at length discharged. 

The carbuncle appears first as a vesicular eruption, roundish 
and jutting forward. The superjacent skin is uneven, wrinkled, 
grayish, and under it there is a dusky yellow, or even blackish 
fluid. When this has been discharged, there is a dark gangrenous 



204 AMERICAN HOUSEHOLD BOOK OF^MEDICINE. 

surface unaerneath. If common matter form, after a time, tlie 
part heals slowly ; if not, gangrene spreads. 

Livid, or pale purplish spots, like flea-bites, appear, and large 
streaks or blotches, like dark bruises, occur in some cases. 

Those cases in which buboes arise early are favorable ; and also 
when the swelling is firm and unyielding to the touch, not gen- 
erally adherent, and is easily moveable at its base. 

The slighter the fever the better; the absence of vomiting is 
favorable, and the patient living on to the eighth day. 

Causes. — Epidemic influence ; contagion. The plague may lie 
latent or concealed for thirt}^ days, it is said ; but the latest report 
of the Paris Academy of Medicine gives eight days as the maxi- 
mum of incubation; so that if a person sustain no attack after 
being exposed to danger for eight days, he may be considered to 
have escaped. Goods, woolens, cotton, etc., will convey the poison 
from place to place. 

Treatment. — Usually there is little to be done in the way of 
treatment; for every thing is instantly rejected by the stomach. 

Still small pieces of ice may be SAvallowed, and calomel with 
camphor may be tried, as in No. 32, only in smaller quantities. 

Cold applications to the head are useful. A poultice, with 
powdered opium sprinkled over it, to the pit of the stomach, or 
opiate liniment. 

No. 61. Of soap liniment 6 oz. 

Tincture of opium 2 oz. 

Mix. 

Rub gently into the pit of the stomach night and morning, 
about a table-spoonful of this liniment. 

The buboes, or carbuncles, should be encouraged to suppurate ; 
that is, to form matter by poultices frequently renewed; and if 
gangrene, or much fetid smell, is perceptible, the charcoal or 
chlorine poultice. 

Brandy and water, or wine and brandy, should be got down, 
by tea-spoonfuls even, so as not to excite vomiting. 

Acid drinks at pleasure. As soon as nourishment can be 
borne, give jelly, beef tea, etc. 

To disinfect goods, follow Dr. Henry's recommendation of 
putting them into a heat of 220° Fahrenheit. He thinks the air 
charged with the plague poison remains stagnant in the inter- 
stices of the goods, and that heat can alone disinfect them. 



VESICULAR EKUPTION— NETTLE RASIt-SHINGLES. 205 

Measles, or Rubeola. (See Diseases of Children.) 

Vesicular Eruption, or Pemphigus 

This disorder is characterized by eruptions dispersed over dif- 
ferent parts of the body, which eruptions assume the form of -vesi- 
cles, about the size of a split pea, increasing to that of a large 
nut, and contain a yellow fluid. The fluid soon becomes pinkish 
in color, and turbid ; then the vesicle, or bladder, bursts, or else 
it dries up into a dark-colored crust. If it burst, the skin under- 
neath it is in a sort of irritable or excoriated state. Successive 
crops appear and disappear in three or four days, causing much 
exhausting irritation in children. 

These vesicles sometimes attack the interior of the body, causing 
symptoms of irritation corresponding to the part afi'ected. There 
is an acute form, attended with fever, and a chronic form. It sel- 
dom attacks adults, but it may prove dangerous to weak children, 
and when the bowels are afi'ected. It may be contagious. 

Treatment. — Observe the kind of fever which co-exists, and act 
accordingly. Tonics are usually required early. If the -bowels 
sufi"er, see Aphtha, or Thrush in Children. Puncture the vesi- 
cles. Apply spermaceti ointment to the ulcers. 

Nettle Rash — Urticaria. 

Slight fever, with an eruption, as if the person had been irri- 
tated by nettles, with great itching. It may continue an indefinite 
time, and may appear or disappear at intervals; usually recedes 
in the day-time, reappearing in the evening. 

Causes. — Suppressed perspiration, irritating diet. 

Treatment. — By a cool regimen, mild aperients, tonics. 

Shingles, or Zona. 

The eruption occurs about the waist, extending half round the 
body; small distinct vesicles; skin of purplish red hue; great 
itching and heat, with fever. Rarely met with except in the 
young. It has been known to terminate fatally. The vesicles 
dry and scale off". After some weeks, the eruption and symptoms 
give way and vanish. 



206 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Treatment. — Keep the patient moderately warm; give tepid 
diluents, gentle aperients. 

No. 62. James's powder 3 grs. 

Dover's powder 5 grs. 

Every night, and again once or twice in the day. 

If the itching is very troublesome sprinkle starch powder over 
the breaking or broken vesicles. Use tonics. 

If there is much pain, thirty grains of watery extract of opium 
to one ounce simple cerate will relieve. If we apply a strip of 
blistering plaster near to where the vesicles are likely to appear, 
the extension of the disease will be checked, the vesicles will 
shrivel, and the progress of the disease be cut short. The blister 
must not be applied over the vesicles but near to them only, or 
gangrene might follow. 

Miliary Fever. (See Diseases of Women.) 
Hemorrhages, or Blood from Various Parts. 

Bleeding at the Nose — Epistapis. 

After a sense of weight in the head, flushed face, giddiness, 
buzzing in the ears, blood is discharged from the nostrils in vary- 
ing quantities. 

Treatment. — As this hemorrhage may be giving relief to an 
overloaded state of the blood-vessels in the head, we should ascer- 
tain if s^^mptoms of fullness of head have existed; but in all cases 
purgatives are useful. 

Powdered charcoal may be snuffed up the nostrils, or plugs of 
lint rolled in this powder m^ay be put up, or plugs wetted with 
this lotion: 



No. 63. Sulphate of zinc 1 dr. 

Sugar of lead 10 grs 

Distilled water 10 oz. 



Or alum-water, used in like manner, two drachms to a half a 
pint of water. 

When faintness impends, we should try to arrest the bleeding 
directly. Absolute rest and quietness, with the head erect ; cold 
cloths or ice to nape of neck, or behind the scrotum ; a cold key 
to nape of neck will sometimes arrest ; plugs once introduced 



VOMITING OF BLOOD. 207 

must not be hastily taken away ; diet according to the state of 
the strength. 

Spitting or Coughing up of Blood. (See Consumption.) 

Vomiting of Blood — Hematemesis. 

This is usually preceded by a sense of weight, oppression, and 
anxiety, at the pit of the stomach. There is usually no cough. 
The blood is discharged in some quantity; it is of a dark color, 
and is often mixed with sundry contents of the stomach. Blood 
also passes from the bowels, and the stools are blackish or dark- 
colored, the blood having been acted upon by the acid it meets 
with in its passage through the bowels. Clots, or co^gula, are 
observed in the fluid ejected, and it thus differs from the black 
vomit of certain fevers in hot climates. Discharges of blood 
may occur in severe scarlet fever, or sore throat, and other dis- 
orders, attended by great prostration of strength. 

Causes. — Suppression of discharge from piles, or other sup- 
pressed discharges ; certain poisons or irritating matters in the 
stomach ; ulcers in it ; organic disease of stomach, when the 
blood is of brown color, and mixed, as above described, with 
other matter. Danger does not so much arise from the quantity 
of blood ejected at once, as from repeated attacks. 

Treatment. — If there is too great a fullness of the system, some 
blood may be taken from the arm. FoIIoav by low diet. Iced 
water or ice ; keep the bowels open by gentle aperients ; ice to 
the pit of the stomach. 

No. 64. Dilute sulphuric acid 15 drops. 

Water 1 oz. 

Tincture of opium 10 drops. 

Syrup 1 drachm. 

Every four hours. 

Or the acetate of lead and opium. (See Spitting of Blood.) 
Some strongly recommend oil of turpentine, ten to thirty drops, 
mixed in an ounce of water, with one drachm of mucilage of 
gum arable. If organic disease is acting as a cause, we must 
act accordingly. 

Immoderate Flow of the Menses. (See Diseases 
OF Women.) 



208 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



Piles — Hbmorrhois. 

Piles may protrude externally, or they may exist within the 
bowel. There is a sense of weight in the back and loins, flatu- 
lency, giddiness of head, sickness on going to stool, a sharp pain 
is felt at the time, and continues, if the piles do not burst ; when 
they do, relief is experienced. 

When they bleed, they are called bleeding piles ; when they 
do not, they are called blind piles. 

The bladder is sometimes affected, and there is a desire to pass 
water frequently. 

They may induce inflammation in the part, or matter may 
form; an^ when much blood is passed, or there is a frequent; 
discharge of blood, much debility results. 

Causes. — Costiveness, hard motions, hard riding, pregnancy, a 
pressure of tumors ; suppression of any habitual discharge ; a 
full state of the veins in the belly or liver ; intemperance ; or 
piles may act as a safety-valve to prevent apoplexy, from too 
full vessels in the head. 

Treatment. — If the piles are salutary in reducing the fullness 
so often observed in stout elderly people, who are fond of eating 
and drinking, we must be cautious how we arrest the bleeding. 
We must first reduce the fullness of habit by mild purges, re- 
duced diet, etc. ; but if the bleeding is causing debility, we must 
arrest the flow as soon as we can. 

One principal rule is to get the bowels into such a state as 
that the motions should be always soft ; active aperients are to 
be avoided, for they will cause a bearing down. 

Sulphur is one of the best aperients in cases of piles. 

No. 65. Washed sulphur 1 oz. 

Lenitive electuary, that is, confection of senna 2 oz. 

Powdered jalap J oz. 

Syrup enough to form an electuary. 

Take of this a bit of the bulk of a walnut, whenever the mo- 
tions are becoming hard. 

When the liver is suspected not to be acting properly, give 
twenty-five drops of tincture of colchicum seeds, with twenty 
drops of liquor of potash, in some barley-water night and morn- 
ing, till the motions become soft. 



Locally, astringents may be applied. 



BLOOD FROM THE KIDNEYS AND BLADDER. 209 

Ointment for Piles. 

No. m. Sugar of lead 1 dr. 

Powdered opium J- dr. 

Spermaceti ointment 1 oz. 

Mix. 

Apply some of this night and morning. 

If the outward piles are hot and irritable, a cooling or evap- 
orating lotion ; or a few leeches near to, but not on, the part. 
Pressure within the bowels, by some India-rubber articles made 
for the purpose. Linen or lint wetted with sulphate of zinc, one 
drachm in water, eight ounces, may be applied. Some recom- 
mend the balsam of copaiba for the painful piles, thirty to forty 
drops, night and morning. Others give cubebs, twenty grains, 
twice a day. Ward's Paste is often useful. 

Ward's Paste. 
No. 67. Elecampane root, powdered; 
Black pepper; 

Fennel seed, powdered; S^each 1 lb. 

Clarified honey: 
White sugar, 

Mix the first three, melt the last two into a syrup, and mix all 
together. 

The bulk of a nutmeg to be taken twice or thrice daily. 
A rectum bougie, or a common candle, may be introduced. 
Diet, very unirritating. 

Blood from the Kidneys and Bladder — Hematuria. 

An evacuation of urine, mixed with blood, preceded by a sense 
of weight or pain in the loins. There is a deposit of coagulated 
blood at the bottom of the vessel. 

We must take care that the blood comes from the bladder, a.nd 
not from piles. 

When blood comes from the kidney it is generally equally dif- 
fused through the urine, and small cylindrical portions of fibrine, 
resembling worms, come away. Blood from the bladder comes 
away after the urine has been discharged, the urine having flowed 
off nearly pure, and the sense of heat and pain are at the bottom 
of the belly. 

The blood may come not from the bladder but from the ure- 
thra (the passage from the bladder) ; it then comes by drops, or in 
14 



210 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

a stream, unmixed with urine ; neither is it accompanied nor pre- 
ceded with a desire to make water. 

If we want to make sure that the deposit is blood, boil the 
urine, and it will furnish a brown coagulum; the fluid part re- 
gains its natural urine color. The blood may meet with acid in 
the urine, when it becomes blackish. In indigestion, the urine 
often deposits a sediment; but this, by heating, is redissolved, 
which blood would not be. 

The urine, in jaundice, looks as if blood w^ere in it; but cloths 
dipped in it are dyed yellow. The system may sympathize more 
or less. 

Causes. — Hard riding; a stone in the parts; malignant disease 
in the bladder is attended with a deposit in the urine, resembling 
blood; but it is not blood, and is of a peculiar color. 

Certain substances, when eaten, will redden urine; the prickly 
pear or Indian fig, beet-root, madder. 

Treatment. — Gentle aperients.* The most direct astringent is 
probably the gallic acid. 

No. 68. Gallic acid 5 gr. to 8 gr. 

Mucilage of gum arabic 1 dr. 

Tincture of henbane 20 drops. 

Water 1 oz. 

every three or four hours. This a powerful remedy. 

Or the acetate of lead and opium. (See Spitting of Blood.) 
Or this: 

No. 69. Bruised whortleberry leaves i oz. 

Boiling water. 1 pint. 

Let it stand for two or three hours; when cold, strain. 

No. 70. Of this infusion. 1 oz. 

Tincture of kino -J oz. 

Syrup 1 oz. 

To be taken in the day. Or this: 

No. 71. Tincture of muriated iron 10 drops. 

Spirits of nutmeg 1 dr. 

Water 1 oz. 

Three times a day. 

A cold hip bath ; or, ice up the lower bowel. Drinks of bar- 
ley-water, gum-water, etc. If any gravel is passed at the same 
time, give alkalies, for which see Gravel. 



APOPLEXY. 211 



Apoplexy. 



There are forms of head disease which sometimes exist inde- 
pendently, or as symptoms of apoplexy. They are: 

Lethargy — which is a disposition to sleep, from which the per- 
son can be roused, will answer questions, and seems at other tiiaes 
as much awake as usual. 

Coma is a greater degree of sleepiness than we observe in leth- 
argy. The person can be roused for a moment, but he speedily 
relapses into his state of sleepiness. 

Cams is deeper drowsiness than coma, and the person can not 
be roused at all. 

Apoplexy has been divided into the sanguineous and serous, the 
former occurring with signs of fullness of the vessels, the latter 
in old people. 

The sanguineous kind attacks suddenly; the powers of sense 
and motion are abolished; the countenance is flushed; the temples 
throbbing ; the pupil of the eyes dilated, sometimes contracted (in 
the most fatal cases) ; foaming at the mouth, and a motion as if 
the mouth were smoking a pipe ; the respiration is snoring, what 
is called stertorious; grinding of the teeth, in some cases; the 
stools are passed involuntarily. 

This kind of apoplexy may be preceded by various head symp- 
toms, as giddiness, dimness of sight, drowsiness, loss of memory, 
or stuttering, or hesitation and loss of speech. 

After the apoplexy has continued some time, the pulse becomes 
languid and the breathing more and more impeded, until it is 
stopped altogether. 

The attack of what is called by some Serous Apoplexy is usu- 
ally more gradual. A pale and humid face ; a small, weak pulse, 
which may be regular or intermitting ; giddiness ; heaviness ; im- 
peded speech, or loss of memory may precede. 

After a time the patient lies prostrate and unconscious, with 
pallid face, and coldness of skin and feet. 

Both the sanguineous and serous kind depend upon one similar 
state, and they only differ in the symptoms just described. 

After the patient has continued in this state some time, par- 
alytic symptoms supervene; and if recovery or amendment do 
not ensue by the third day, a fatal result may be apprehended. 

Causes. — A certain age predisposes; and all who have passed 



212 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

their forty-fifth or fiftieth year should cautiously avoid the causes. 
A state of fullness of vessels ; that is, of the arteries in the head, 
or of veins in the belly ; a short neck and large head ; a luxurious 
life ; over-eating and drinking, with sedentary habits ; great study ; 
suppression of any habitual discharge, or of any cutaneous erup- 
tion ; certain cases of heart disease; all these predispose. The 
exciting causes are: Violent mental emotions; sudden cold; vio- 
lent exercise in those predisposed; certain postures in which there 
is straining in the head vessels ; tightness of ligatures round the 
neck ; all excesses ; derangement of stomach ; certain poisons, and 
fumes of certain substances. 

Treatment. — In the plethoric, or sanguineous kind, we must 
bleed largely, and perhaps repeatedly, for the vessels must be 
unloaded. So long as the pulse keeps up with considerable power 
we may bleed. 

Leeches or cupping-glasses should be applied. 

Sharp purges, as croton-oil, one or two drops put on the 
tongue; or this: 

No. 72. Epsom salts 1 oz. 

Powdered jalap ^ oz. 

Infusion of senna 4 oz. 

Half to be given directly, and the other in four hours, if the 
former have not operated; but as the power of swallowing is fre- 
quently lost in these cases, we must rely on the croton oil, put on 
the tongue as above directed. 

When the bowels have been freely opened, and as much blood 
taken away from the arm as the patient will bear, we should give 
calomel and antimony powders. (See No. 32, in Phrenitis.) If 
there be much vomiting, the antimony must be omitted, and the 
calomel alone given. 

See that the bladder is emptied every day. 

When the apoplectic signs still continue, leeching and cupping 
may be repeated — so long as the skin retains its heat, and the 
pulse some strength — but when, after some time has elapsed, little 
or no amendment ensues, even although the calomel have caused 
a swelling and tenderness of the gums, little hope remains of re- 
covery from active treatment. 

The calomel should not be omitted, because if any remedy will 
repair the damages caused by the apoplexy, or remove a con- 



APOPLEXY. 213 

gestive state, tlie mercury is most likely to do so; and if the 
calomel powders can not be given, the writer would order one 
drachm of liniment of mercury, to be rubbed every night and 
morning into the interior surface of the thighs, or the back of 
the neck, until the gums are tender. In most cases the calomel 
powders can be administered, by putting on the tongue three 
grains of it, with or without the antimony, as it may be, and 
without any gum arable powder, in order to lessen the bulk, and 
they will slowly pass down into the stomach. 

Emetics have been recommended, when the attack takes place 
soon after a full meal; but they should never be given in this 
kind of apoplexy— the plethoric or sanguineous. We should 
remove the contents of the stomach by the croton oil, or some 
other active purgative. The emetic has seemed, in more than 
one case, to have increased the oppression of the brain in a 
marked manner. 

Purgative lavements may be administered. 

For local applications, cold to the head, pounded ice, etc. 
The diet should consist of light drinks, and no nourishment at all. 

As to the serous variety of apoplexy, the treatment does not 
require to be so energetic as in the sanguineous ; still, we must 
lose no time. 

Blood-letting will seldom be necessary; and if there be cool, 
or cold skin, with pallid face and small pulse, blood-letting might 
do harm. Then leeches to the head or temples, and repeated 
cupping to the back of the neck. 

Purgatives are here extremely useful. 

In this form, too, blisters to nape of neck ; mustard poultices 
to the feet ; warm baths to the feet, with flour of mustard in 
them, while cold is applied to the forehead and head. 

Here, again, as a congestive state of the brain exists, the 
calomel ought to be given, until the gums become tender. 

If symptoms of sinking appear, the author has never seen ad- 
vantage derived from ammonia, ether, camphor, and wine; for 
the case does not consist of mere prostration or debility, as in 
some of the preceding diseases ; but there is a congestion, prob- 
ably with an effusion of serum on the brain, which is not likely 
to be removed by stimulants. They must, however, be tried. 

When the acute signs cease, and the state of palsy is left, we 
must treat as for palsy. 



214 AMEEICAN HOUSEHOLD BOOK OF MEDICINE. 

In no case, probably, is the adage of prevention being better 
than cure, more applicable than in. the case of apoplexy; and it 
is no exaggeration to say, that very much may be done, not only 
to prevent an attack of apoplexy, but even to remove, in a great 
measure, the apoplectic tendency. 

The first point to be attended to in this preventive system is 
the diet, both as to the quantity and quality ; the next, the mind, 
as to mental emotion and excitement. The quantity must be 
adapted to the powers and state of circulation of the individual. 
In those of a weak habit, with cold skin and poor, weak pulse, 
the diet may be plainly nutritious ; but even in these habits, 
where there is a tendency to what is called blood to the head, 
stimulants should be cautiously tried, and perhaps had better be 
abstained from altogether. The breakfast should consist of tea, 
with bread and butter, and, in the weak habit, an egg may be 
added, if it agree with the person. The dinner should be at an 
early hour — twelve or not later than two o'clock — and may con- 
sist of a moderate portion of well-dressed mutton, with well-boiled 
potatoes or other vegetable. At tea-time, mere diluents ; and at 
bed-time, no supper of any thing but gruel and milk, or barley- 
water and a biscuit. 

Coffee has been prohibited by Br. Eberle, in his practice of 
physic, as being " decidedly injurious when there is an apoplectic 
tendency ;" and he mentions a case of apoplexy in a gentleman 
" who was in the habit of taking large quantities of very strong 
coffee twice daily." Dr. Eberle adviseH him to leave it off, and 
apoplexy "never recurred, and even the ordinary premonitory 
symptoms left him." To tea. Dr. Eberle has no objection; but 
I must remark that the gentleman mentioned took coffee immoder- 
ately, and very possibly he was exposed to much mental excite- 
ment and anxiety, perhaps from speculations in business, etc., 
which excitement would be more likely than coffee to excite dis- 
ease. At all events, the writer has never seen any harm arise 
from coffee moderately drank. Theine and caffeine are identical 
as to components, says the chemist ; and if any apoplectic per- 
son were very partial to coffee, the author would not be deterred 
from allowing it to be taken in moderate quantities, but not 
made too strong. 

Tea is perhaps preferable, and green tea has been much 
praised as a preventive. In the person of plethoric habit, who 



APOPLEXY. .215 

lias been threatened with, or has suffered an attack of apoplexy, 
the diet must be so reduced in stimulant, and even nutritious 
material, as to demand the sternest resolve in the patient to per- 
severe. Few people, even in these days of so-called civilization, 
have energy and strength of mind enough to follow up such a 
system of diet as would be best fitted to prevent attacks of^this 
disease. Such persons it is in vain to tell that every full meal 
is full of danger to life ; that it is like the sword of Damocles, 
ever ready to fall. The gratification of the palate, and the en- 
joyment of its pleasures, overpower, overwhelm all other con- 
siderations ; and their answer to all well-meant advice and re- 
monstrances has been, that though they might add some ten or 
more years to their lives, by following implicitly directions here 
laid down, yet such a state of mortification and self-denial would 
to them render existence a burden; it would not be enjoying 
life, for it might be considered no better than a state of vege- 
tation. If any of our readers have elderly relatives so situate, 
and thus obstinate, the writer would advise, as the next best mode 
of acting under such a suicidal system, that they should induce 
the threatened persons to take frequently sharp purgatives. In 
this way the blood-vessels do not fill so quickly as they would 
otherwise, nor does the blood become so rich in inflammatory 
elements — if the word rich may be allowed. 

The tincture of colchicum-seeds is useful as a preventive. 
Forty drops in water every night, until they can no longer be 
borne, I have given with advantage. 

The tepid, or cold shower bath, every morning, or whenever 
the giddiness, throbbing, or head symptoms show themselves, 
must be employed; but always the person must, before the 
shower fall, sit or stand with the feet in as hot water as can be 
borne comfortably. This is important. All tight ligatures 
around the neck to be avoided ; also acts of stooping, as in tying 
shoes, picking up any thing from the ground, etc. ; also straining 
at water-closet. 

Violent exertions or exercise may bring on an attack ; abuse 
of any pleasure. Excess in venery is peculiarly fatal in some ; 
and many a person has thus been sent to answer all his doings 
and sayings in this world when he was least prepared. Intem- 
perance is highly prejudicial. 

Where any discharges have been suppressed, or eruptions, or 



216 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

bleeding from piles liave been suddenly stopped, blisters and 
mustard cataplasms, or stimulating liniments, may be applied ; 
and in tbe case of piles, leeches to the perineum must be from 
time to time resorted to. 

See a case, under the head of Erythema, showing how the 
injudicious suppression of a rather slight inflammation gave rise 
to apoplexy and death. 

Where gout has seized on a joint, and is suddenly translated 
to the brain, we generally find that there is a coexistent, or that 
there has been a preceding state allied to debility ; then purga- 
tives and stimulants will be required, according to the patient's 
peculiar condition at the time. 

Palsy, or Paralysis, 

is a diminution or total loss of the powers of motion, and sensi- 
bility in certain parts of the body. 

It may involve a loss of power over one side of the body from 
the head downward, and is then called hemiplegia ; or it may 
affect one-half of the body, taken transversely, and is then called 
paraplegia. 

Besides these, there are partial palsies, certain muscles being 
alone affected. This kind may arise from poisons, as from the 
fumes or absorption of lead, in painters and glaziers. 

Hemiplegia sometimes follows an attack of apoplexy ; at others, 
it occurs independently. 

Symptoms. — Voluntary motion or sensation, or both, are abol- 
ished in certain parts of the body ; sleep, and slow, soft pulse ; 
torpor, giddiness, pain in the head, loss of memory ; sense of 
numbness, of creeping or pricking in the affected parts. The 
eye and mouth may be drawn on one side ; the judgment is im- 
paired, and the speech more or less incoherent. 

A decline of energy is often the precursor ; and after long 
continuance of the disease, the muscles of the paralyzed part 
become, from disuse, flaccid and diminished in size. 

The partial palsies will be described below. 

When the brain, heart, or lungs are attackecl, death soon en- 
sues. 

Causes. — ^Whatever tends to compress the brain ; impaired nerv- 
ous energy, determination of blood to the head after suppressed 



PALSY, OR PARALYSIS. 217 

discharges or eruptions on the skin, apoplexy, certain poisons, old 
age. 

A sense of pain or of itching, with a return of sensation in the 
parts, is favorable; so also is the return of any previously sup- 
pressed discharge. The more vigor remaining, the more favor- 
able. 

The palsy of the left side is said to be more dangerous than 
that of the right, and of the arms than of the legs. 

Treatment. — If any apoplectic tendency remain, cupping or 
leeching, or even blood-letting, with purges, and then we must 
not be too busy, but leave to time and nature to effect a recovery. 

If elderly persons of weak powers are our patients, we must 
keep up the strength, use the flesh-brush, and give stimulants. 

One tea-spoonful of mustard, thrice daily, in some water, or one 
of the following: 

No. 73. Compound spirits of aininonia i- dr. 

Compound tincture of cardamoms 2 drs. 

Syrnp , 1 dr. 

Mint, or peppermint-water 1 oz. 

Give every six hours. 

No. 74. Bruised horse-radish roots 2 oz. 

Mustard seeds 
Valerian root 

Rhubarb root, cut small i- oz. 

Sherry. . . .' 2 pts. 

Give two table-spoonfuls every fourth hour. 

No. 75. Carbonate of ammonia 6 grs. 

Compound spirits of sulphuric ether.... 1 dr. 

Ginger syrup 1 dr. 

Camphor mixture 1 oz. 

Give about every four or six hours. Some recommend guaiacum 
in the following form. 

No. 76. Powdered guaiacum 10 grs. 

Ammoniated tincture of guaiacum 1 dr. 

Powdered gum arable 40 grs. 

Water 1 J oz. 

Give every four hours. 

One of the following liniments may be rubbed over the parts : 

No. 77. Tincture of cantharides 1 ^f « -u -i 

Soap liniment j ®^* 

Mix. 



I of each 2 drs. 



218 AMEEICAN HOUSEHOLD BOOK OF MEDICINE. 

No. 78. Powdered mustard seed 1 dr. 

Acetic acid ^ oz. 

Soap liniment 1^ oz. 

Mix. 

No. 79. Tincture of eantharides 1 oz. 

Spirits of turpentine -J oz. 

Camphor liniment ^ oz. 

Mix. 

Frequent blisters, or mustard poultices; warm and salt water 
baths ; regular exercise ; hand-rubbing ; galvanism, or electro-gal- 
vanism, cautiously tried. The strychnine is very efficacious ; but 
no one but a medical man should administer such a drug; it re- 
quires constant watchfulness. 

If bleeding from piles have been suppressed, leeches to the 
perinaeum. 

Paraplegia 

often is attended with little or no disease in the brain; and it is 
then functional. 

The same mode of treatment is to be adopted as in hemiplegia ; 
only in these cases much benefit is often derived from the tincture 
of cantharides — thirty drops,, thrice daily, for many weeks. 

It should not, however, be given to women, nor to ai^iy who 
have disease in the urethra (passage from the bladder). 

The cantharides may cause strangury, that is, difficulty and 
pain in passing the urine ; then give barley or toast-water, dilut- 
ing freely with some carbonate of soda in the drink; and ad- 
minister a lavement of starch decoction, two or three ounces, and 
tincture of opium, twenty drops. 

When paraplegia results from disease of the spine, the primary 
disease must be looked to. 

Partial Palsy 

of certain muscles, or of a joint, may follow an attack of fever — 
typhus mostly. The shoulder muscles and those of the forepart 
of the thigh may suffer; or this kind of palsy may be only a 
precursor of hemiplegia. But this kind mostly attacks the face, 
and then great alarm is felt of apoplexy ; but no alarm need be 
felt in almost all the cases. 

"When the nerves of vision are attacked, blindness ensues. 
When certain muscles near the orbit are attacked, the eyelid can 



PARTIAL PALSY 219 

not be raised, nor the eyeball moved by voluntary power, though 
the eyeball rises above the upper eyelid the moment the eye is 
shut. Thus the distinctive symptoms are the dropping of the eye- 
lids and squinting outward. 

When the fifth cerebral nerves are implicated, the muscles sup- 
plied by them are palsied; the muscles on the temples and side 
of mouth are palsied, so they remain flaccid when chewing. The 
sense of taste is lost; one side of the tongue is numb, and the 
eye and nostril of one side are insensible to any irritation; the 
mouth is drawn to one side. 

When the sixth .cerebral nerve suffers, there is a squint in- 
ward — double sight, in some cases. 

The symptoms of diseased seventh nerve are, whole side of 
face flaccid and pendulous; mouth drawn to the opposite angle; 
nothing can be held by the patient between the lips of the affected 
side ; the sound of whistling can not be effected, and on laughing 
or smiling, one angle of the mouth remains at rest, while the 
other is drawn toward the ear. On taking a forcible inspiration 
(drawing in the breath), the nostril on one side collapses, nor can 
the patient dilate it by any voluntary effort. The eyebrow droops, 
and can not be elevated when the other is raised, and the eye- 
lids can not be closed. This eye remains open during sleep, and 
the eye is apt to inflame. 

These appearances are very curious. Sometimes these nerves 
are affected on both sides of the face; but rarely. 

The eighth pah' of cerebral nerves supply the heart, lungs, 
and stomach with nervous influence; and a palsy attacking them 
is as dangerous to life as any attack of apoplexy or hemiplegia 
can be. 

The danger to life is to be predicted in proportion as there is 
evidence of a coexisting or preexistent disease in the brain. 
The palsy of the fifth, eighth, and ninth nerves are usually the 
most dangerous ; but a palsy of part of the fifth is frequently 
caused by exposure to cold, or to cold air, as in a carriage, etc. 
It is curious that Dr. Christison, from whose graphic account of 
these palsies the preceding abstract has been taken, says he has 
met with facial palsy, but never with numbness. 

It must be a comfort to know that these are cases which would 
seem to threaten palsy or apoplexy, yet which involve no danger 
to life, and, moreover, are often easily curable. 



220 AMERICAN HOUSEHOLD BOOK OF' MEDICINE 

Treatment. — ^Blisters, to be repeated, or croton-oil liniment may 
be rubbed in ; so may other stimulating embrocations. A warm 
drink in bed at night, with a dose of James's powder to elicit 
perspiration. 

If these do not remove the symptoms, give what are called 
alterative doses of calomel — one grain three times a day; but 
salivation must be avoided, and the gums, therefore, must be 
watched, so as to stop in time. 

If the patient be in bed, add tartar emetic one-sixteenth of a 
grain, or three grains of James's powder, to each dose. 

Indigestion — ^Dyspepsia 

is thus described by Cullen : Want of appetite, nausea, vomiting, 
flatulency of stomach, acid eructations, rumination, heartburn, and 
pain at the pit of the stomach, with costiveness. 

One or more of these symptoms are met with, and sometimes all. 

Symptoms. — To those above stated, general debility, languor, 
and aversion to motion; depression of spirits, sense of fullness 
and oppression after eating ; heartburn very troublesome ; appetite 
irregular; costiveness, or sometimes diarrhea; small pulse, quick- 
ened after eating, or on exertions being made; perhaps palpita- 
tion; flushed face after eating; tongue dry, and mostly white in 
the morning ; urine may deposit, and usually does deposit, either 
a red sediment (the lithic or uric acid) or else a white sediment 
(the phosphates), with an oily appearance floating on its sur- 
face ; then the skin and feet become cold ; the face sallow ; head- 
ache, dry skin, or else damp sweats; disturbed sleep, and hectic 
fever. 

The vomiting is a most distressing symptom; it sometimes 
comes on as soon as food has been taken; at others, in one or 
two hours, and the matters ejected are sour. If the vomiting 
continue long, yellow bile will be at last pumped up, giving many 
person^ reason to think that the liver is not performing its func- 
tions properly, and is the cause of the indigestion, whereas the 
bile is ejected by an inverted action of the bowel called the 
duodenum," which is the immediate continuation of the stomach. 

The flatulence and belching may arise from gas, which has 
been extricated from undigested food, detained in the stomach 
in a state of fermentation, or it may have been secreted by the 



IXDIGESTIOX— DYSPEPSIA 221 

stomach itself; for this symptom arises sometimes ■when there has 
been no food in the stomach. The distention caused by this gas 
is very distressing indeed in some cases. 

The pain comes on at various times, and under various circum- 
stances. Dr. Pemberton tells us that it may occur from organic 
disease; but vrhen it forms one of the signs of dyspepsia, it may 
occur when the stomach is empty, and might arise, he thought, 
from an increased and altered secretion of the glands of the 
mucous membrane of the stomach; and, secondly, it may occur 
when the stomach is full, and he thought it arose from irritability 
of the muscular coat, and not from any altered secretion. 

Dr. Abercrombie says pain occurs under four forms. The first 
is observed when the stomach is empty, and is relieved by taking 
food ; as Dr. Pemberton also said, the food enveloping the se- 
cretion, if it is in small quantity ; if it is in large, it is thrown out 
by vomiting. 

The second form is when it arises directly food has been taken. 
Here Dr. Abercrombie suspected undue irritability of the mucous 
membrane of the stomach, or a sub-acute inflammation. 

In a third form, the pain begins after a meal, but not till from 
two to four hours have elapsed; here the pain would seem to be 
in the bowel named the duodenum. 

In a fourth form, the pain is extremely violent, and attacks in 
fits or paroxysms, often affecting hysterical females, shooting up 
to the shoulder, and proving very intractable. 

The remedies for these four forms of pain will be mentioned 
in the treatment. 

By the vomiting, a thin, watery liquid is ejected, sometimes 
sourish, but usually insipid and tasteless. This is the water-brash, 
or, technically, pyrosis. Its paroxysms come on in the morning 
and forenoon, when the stomach is empty, with pain and a sense 
of constriction at the pit of the stomach, as if the stomach were 
drawn toward the back; the pain is increased in an erect pos- 
ture, wherefore the body is bended forward. This water -brash is 
mostly an attendant on organic disease, but not necessarily so. 

Causes. — Every thing which is debilitating to the system or the 
stomach — intemperate use of food or drink, spirits in particular; 
in tea, tobacco, or opium ; imperfect mastication; sedentary habits; 
too much study; certain depressing affections of the mind; errors 
in diet; disease of the liver; hysteria; exposure to moist and cold 



222 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

air ; deficiency or depraved secretion of the bile, or saliva or gas- 
tric juice. 

Treatment. — We must first regulate the diet, both as to quan- 
tity and quality, for the less the stomach is distended beyond a 
certain degree the better ; and we must not forget that the supply 
of the gastric juice is always exactly regulated by the demand 
for it, the quantity of the secretion corresponding with the quan- 
tity of the food. But, then, it must also be borne in mind that the 
amount of the secretion is never greater than the requirements 
of the frame would demand, whence it follows that whenever the 
food is too great, or exceeds the demand of the requirements, a 
portion of the food will remain undissolved, and so disturb the 
due digestion of the rest. 

Then Dr. Abercrombie tells us that various articles of food are 
soluble in various degrees in the stomach ; and, therefore, if in 
a weakened stomach articles of food are introduced of difi'erent 
degrees of solubility, the digestion will not be performed so well 
as it should be. Thus another rule is established in dyspepsia, 
which is, for those threatened with it, to dine off* one dish; for, 
by so doing, we not only avoid an injurious mixture of food, but 
we escape a probability of eating too much, by thus avoiding too 
much provocation or gratification of the taste by new and varied 
flavors. 

The patient should masticate slowly, should eat at regular 
hours, and drink but little during and for a short time after 
taking food; also, active exercise must be avoided, for some two 
hours, at least, after digestion has commenced. 

We must first ascertain whether high irritation or a slight 
degree of inflammation may be suspected to exist in the mucous 
membrane of the stomach, from the tenderness or pain at the 
pit of the stomach, and also from the state of the tongue, which 
is red at its tip and edges, as well as the more frequent pulse 
and greater febrile increase of symptoms in the evening; or 
whether the disease depends on mere debility of the digestive 
organs. In the former case animal food is not admissible, and, 
if taken, it will add to the patient's suff'erings ; then the lightest 
farinaceous food must be taken, while leeches to pit of stomach 
and fomentations, with alkaline fever draughts, are the proper 
medicines for such a state of sub-inflammatory irritation. 

But where there is mere debility of the digestive organs, ani- 



INDIGESTION— DYSPEPSIA. 223 

mal food will be preferable; and meat is to be preferred to ani- 
mal jellies, since jellies remain long in the stomach, from their 
indigestible nature, causing disturbance and distress. 

Meat, again, should be that of full-grown animals, and not of 
young ones ; for more mucilaginous matter is contained in the 
flesh of young than of full-grown animals, and mucilages are o£ 
difficult digestion. 

Tender mutton, beef, or venison, and all kinds of game, are 
usually of easy digestion. Pork and veal are inadmissible. Fish 
will often not agree ; and when eaten, only small quantities of 
boiled fish are allowable. 

Geese and ducks do not suit dyspeptics, while turkey is more 
oppressive than fowl. Fowl is, next to mutton, the lightest of 
animal food, but the skin must be avoided. 

Of game, the pheasant is least easy of digestion ; partridge and 
hare are readily digestible. 

Soft-boiled eggs agree with many persons ; but the peculiari- 
ties of different stomachs as to digesting articles of food are most 
extraordinary; wherefore the medical man can only lay down 
general rules, and leave exceptional cases to each individual's 
own management. The author attended a gentleman who could, 
with pleasure, eat and readily digest a hard-boiled egg ; but if he 
were to eat one lightly boiled, it would stir up an immediate dis- 
turbance in his stomach, and seem to act like a poison or irritant ; 
for there was no ease till some loose, bilious looking evacuations 
had passed from the bowels. My patient was in no degree fan- 
ciful, and was, moreover, a medical man. 

All food should be roasted or boiled; frying is highly objec- 
tionable. 

Some like new-made bread; but no aliment is perhaps more 
offensive to the weak stomach than this. By mastication it is 
converted into a tenacious paste, which is not easily pervaded by 
the gastric fluid. 

Bran bread is useful, especially in costive habits. 

The bowels must be regulated by a pill of blue pill and com- 
pound extract of colocynth, three grains of each, and a seidlitz 
powder next morning ; then, if red tongue and feverishness pre- 
vail, with increased pain from hot liquids, a few leeches to the 
pit of the stomach. 

The distressing symptoms must be alleviated; the 



224 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

VOMITINO 

by reducing the food to what can be easily borne and digested, 
and by the draughts of bicarbonate of potash and hydrocyanic 
acid, No. 7. The carbonic acid is powerful in assisting the vom- 
iting, and the potash acts upon the acid products in the stomach, 
neutralizing the lactic acid, which is formed in imperfect diges- 
tion. Alkalies will be useful so long as the urine deposits an 
acid sediment. It should be tested (see Gravel), and if it be- 
come alkaline instead of acid, the nitric and muriatic acids may 
be given, 5 to 10 drops of each dilute acid. 

Flatulence. 

Peppermint-water and other carminatives, with 20 grains of 
soda ; and for the flatulence which follows eating, take imme- 
diately before the meal 5 grains of extract of rhubarb, with one 
grain of cayenne pepper. For rumination, the soda or potash, 
with a tea-spoonful of sal volatile. 

Pain. 

For the first kind of pain, give a tea-spoonful of the aromatic 
spirit of ammonia, or half an ounce of liquid magnesia in cam- 
phor julep. Food relieves, or ten grains of powdered kino and 
half a grain of powdered opium. For the second, the alkaline 
draught, with tincture of henbane or of opium, 10 or 15 drops. 

The third kind requires also the alkaline draught, as it de- 
pends on acid secretions or formations ; an alkaline draught im- 
mediately after dinner ; warm tea relieves. 

Pyrosis, or Water-brash. 

For the fourth kind, carminatives, mustard poultices. Here the 
compound powder of kino, ten grains, with aperients to obviate 
costiveness. 

Wine or spirits are better avoided throughout. (See Diet.) 

Some of the tonic infusions (see Fever) may be the vehicle 
for the soda or potash. 

Dr. Abernethy says that six hours should be the interval be- 
tween meals; the stomach should get rid of one meal before it 
has to digest another. Medicines may do much good in indiges- 



HYPOCHOXDRIAC AFFECTION. 225 

tion, but tlie only sure preventive is to attend to tlie diet, witli a 
summary of whicli we will close this article. 

Strong coffee, or tea, with toast, for breakfast — sugar and milk 
with the liquids; but as the sugar contains impurities, the author 
has recommended some patients never to use any thing but syrup; 
a hghtly-boiled egg is allowable. 

For dinner, animal food well cooked, but never fried. Mutton, 
venison, some poultry, winged game — but never dressed a second 
time — may be allowed; but fat meat, gelatinous meat (young pig, 
lamb, or veal), and strong soups ; such fish as salmon, mackerel, 
herring; fish-sauces, melted butters are to be avoided. 

Stale bread alone to be eaten; all kinds of pastry bad. 

For vegetables, cauliflower, asparagus, young peas, French 
beans, and mealy potatoes, always well boiled, may be eaten, and 
agree with the majority. 

Fruits had better be eaten before than after dinner — strawber- 
ries, mulberries, peaches, nectarines, oranges, and grapes, may 
be usually eaten; but figs, currants, gooseberries, apples, plums, 
cherries, apricots, melons, and all kinds of nuts should be in- 
terdicted. 

If wine is urgently demanded, good genuine sherry and water is 
the best; the fine, dry, non-acescent wines are alone admissible. 

Hypochondriac Affection, Vapors, Low Spirits, Hypochon- 
driasis. 

This disease, according to Pinel, should be called biophobia; for 
the low spirits of the sufferer have led to suicide at times. 

It occurs mostly in the melancholic. Its signs are sadness, 
want of resolution and activity, fear of danger to life, particular 
attention to health. The bodily functions do not suffer mate- 
rially ; there may be some signs of indigestion in some cases, but 
imaginary sufferings and symptoms are detailed. 

The cause of this singular malady is supposed to be a nervous 
affection of certain nerves, called the ganglionic system — a neu- 
ropathy, technically. 

Treatment must vary with the varying states. Symptoms of 
indigestion are to be treated as in dyspepsia. 

We must not ruffle the sufferer's mind, nor rudely contradict 
him; nevertheless, we must not trust to his statements of his 
15 



226 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

sufferings, for, self-deceived, he details imaginary ones; and tlie 
author has been told of utter sleeplessness, and want of appetite, 
when the servant, who always slept in his master's bed-room, had 
informed him that his master had slept all night like a top, and 
had eaten an excellent breakfast. 

Change of scene, watchfulness, and time very often effect sound 
cures when medicine could do nothing, except in the relief of 
urgent symptoms. 

Hysteria. (See Diseases of Women.) 

Epilepsy. 

A sudden deprivation of the senses, with violent convulsive 
motions of the whole body, characterize this dangerous and alarm- 
ing disease. 

The fit comes on at uncertain intervals, and lasts a longer or 
shorter time — -generally from five to ten minutes. 

A cry precedes sometimes, or a feeling as if a stream of cool 
air were passing over the arms and legs upward toward the 
head; the convulsive motions of the limbs and body are violent; 
facial muscles are distorted; eyes fixed and staring, or turned 
upward; hands clenched, thumbs turned in upon the hands; face 
swollen and livid ; foam or froth issues from the mouth ; the tongue 
often bitten ; the excretions are expelled involuntarily. To all 
these urgent symptoms a state resembling sleep succeeds, but it 
is only insensibility, which, however, is followed by a sleep of some 
hours. 

The attack is usually at night, while asleep; and thus these 
convulsive motions differ from those in St. Yitus's dance, by the 
latter occurring in the day mostly. 

The causes are various, some capable of removal, others not so, 
being dependent on incurable organic disease. 

Treatment of a curative nature, it must be candidly confessed, 
ought well-nigh to be despaired of, unless in cases arising from 
irritation in the bowels or elsewhere, which produces an effect 
on the brain, through what is now called the reflex system of 
nerves. 

Here treatment is effective, and the author has treated several 
such cases, and might have deluded himself into a belief that epi- 
lepsy was much more curable than it is. In some cases, worms 



EPILEPSY. 227 

have been exciting such fits, and worm medicines, with tonics, 
removed all attacks; in others, there have been irritating secre- 
tions in stomach or bowels. Here he has given: 

No. 80. Calcined magnesia 1 dr. 

Epsom salts 1 oz. 

Dilute hydrocyanic acid 8 drops. 

Peppermint, or distilled water, or in- 
fusion of gentian 8 oz. 

Two table-spoonfuls two or three times a day, as the bowels 
are acted upon. The Epsom salts may either be diminished in 
quantity after a time, or discontinued altogether. 

If the fits leave behind them a state of congestion, as shown 
by a clouded state of the mental faculties, giddiness, etc., five 
grains of blue pill, or one grain of calomel for four or six nights, 
would be useful. 

The worm remedies are detailed under the head of worms. 
Suppressed evacuations should be reestablished, if possible. 

An attack between the fourth and tenth year is often curable; 
but if it arise in one who has attained twenty-five years of age, 
it is apt to continue during that person's life ; this is, however, 
not invariably the case. Remove all exciting causes that are re- 
movable. 

Epilepsy forms one of the most fertile fields for the quack that 
can be devised. The more incurable the disease, the greater num- 
ber of infallible remedies are proclaimed; all of them are tried 
with eager hope, and with excellent profit to the quack, whose 
promises of cure rise with the occasion. 

Ammoniuret of copper, oxyde, and sulphate of zinc, nitrate of 
silver, arsenic, wormwood, the wall pennywort, or cotyledon umbili- 
cus, the root of the peony, the agaricus muscarius, artemisia vul- 
garis, or mugwort, with a long list of other so-called specifics, may 
be mentioned. But there is no known specific, and treatment must 
vary according to the state of the patient. 

A late writer in the London Lancet of February, 1854, says : 
"A rational investigation must be made as to whether there is 
exalted sensibility or a tonic lethargy, whether there is conges- 
tion or repletion." 

He suggests, where there are warning signs, to administer a 
lavement of one ounce spirits of turpentine in eight ounces of 
warm gruel, and to apply mustard poultices to nape of neck. 



228 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Dashing cold water in tlie face is sometimes useful. 

Where there is a full habit, nothing but lowering the diet, to 
what many would call starvation point, will prolong life, and 
prevent attacks in such persons. 

The writer attended, some years ago, the father of a family 
of ten children, all solely dependent on his exertions, whose life 
was repeatedly endangered by the violence and frequency of the 
fits. He was put upon a very spare diet of vegetables and fari- 
naceous food, neither touching meat nor even fish. No medi- 
cines, except an occasional aperient, were given. He has now 
survived many years, and, though thin, is very active in his 
business, traveling and bustling about with his bit of dry, brown, 
branny bread in his pocket. 

If, on the contrary, the patient is of weak powers and debili- 
tated habit, the diet must be nutritious, though as unstimulating 
as possible ; and meat once a day, with some green vegetables, may 
be advised; ham and bacon to be avoided; beer (not sour), cocoa, 
tea, or coffee may be allowed. 

Sleep on a mattress, and avoid excitement of mind or over-ex- 
ertion of body. During the fits, cold to temples and forehead, 
or cold douche in a few cases; with flushed face, beating of tem- 
ples, and bounding pulse, blood-letting, or leeches. Let not the 
patient receive hurt during the struggles and convulsive move- 
ments ; put a bit of soft wood between the teeth, and have help 
to keep the patient down. 

The main point to look to is the prevention of fits by atten- 
tion during the intervals ; and as we never can be sure whether 
the disease is incurable or not, we should cautiously try any 
remedy which may be tried by an unprofessional person. 

Arsenic, the nitrate of silver, and some others, should only be 
prescribed by the medical man. 

St. Vitus's Dance. (See Diseases of Childken.) 

Sardonic Laugh 

consists of a violent fit of laughing, arising from no evident 
cause, and continues for three or four nights, preventing sleep 
and causing debility. It is so called from similar symptoms 
arising from eating a poisonous herb growing in Sardinia. 



TETANUS, OR CRAMP. 229 

Little can be done by medicine. Opium sbould be given, and 
musk, assafetida, camphor, and ether may be tried. 



Tetakus, or Cramp. 

This disorder is a fatal one when severe, and it may arise fpom 
wounds or bruises which are apparently shght. It is, therefore, 
either symptomatic, or it may arise from exposure to cold when 
perspiring. The latter kind is not unfrequent in hot countries, 
rare in Europe. 

Symptoms. — No premonitory signs; stiffness of jaws, pain and 
oppression at pit of stomach; the teeth become closed. This is 
trismus, or locked jaw. 

The spasms extend to the muscles of the back, when the pa- 
tient lies resting almost on head and heels, the spine forming an 
arch; or the muscles on the front of the body are affected; then 
the body is bent forward, the belly feels hard as a drum, the spasm 
extends to the arms. 

The intellectual functions are not implicated. 

The fits recur every ten or fifteen minutes; violent pain from, 
stomach to back causes much suffering, the eyes are immovable, 
and the face is peculiarly and shockingly distorted, till a fatal 
spasm takes place, and death. 

When it proves fatal, death happens before the tenth day; but 
Professor Robinson records a case of a negro, whose thumb was 
lacerated in breaking a china dish, which caused death in a quar- 
ter of an hour. 

Dr. James O'Beirne says the period of recovery may extend 
from eighteen days to eight or nineteen weeks, and there are no 
critical symptoms. 

Causes. — Predisposing are — the male sex — a vigorous, pleth- 
oric habit, warmth of climate, autumnal season. 

Exciting are — exposure to cold, or to excessive heat, injuries, 
in the shape chiefly of lacerated (torn, ragged) wounds, which 
penetrate the sheaths of muscles (called fascia) ; those which do 
not penetrate the fasciae are not followed by tetanus, nor does 
it attack often after the wound has cicatrized (healed), nor dur- 
ing the inflamed state of a wound ; it does not supervene upon 
burns, scalds, nor injuries of the skin, provided such injuries do 
not affect the fasciae. 



230 AMERICAN HOUSEHOLD BOOK OF. MEDICINE. 

This kind of tetanus arises in from four to seventeen days after 
the infliction o? the wound. 

Irritations of stomach or bowels; mental emotions are also causes. 

We may indulge some hope of recovery when cold has been the 
originating cause, when the fits are not very frequent, and do not 
quickly advance to a violent degree. 

Treatment. — Acute tetanus is fatal, under almost every kind of 
treatment, and the writer has seen almost every remedy which has 
been recommended tried in vain. 

Opium has answered best in large quantities ; one lady took 
forty thousand drops daily, and recovered — cured one dare not 
say. 

The only remedy from which any benefit was derived in the au- 
thor's practice was tobacco, in form of clyster; for the clyster 
relaxed the locked jaws long enough to permit nourishment to be 
given. The benefit was, however, only temporary. 

But Dr. James O'Beirne's plan seems the only one likely to 
do permanent good. By it eleven out of twenty cases recovered. 
He threw up lavements of tobacco by a long clyster tube, so 
long as to throw the fluid high up into the bowel. To do this, 
requires care in introducing the pipe. 

Tobacco Clyster. 

No. 81. Tobacco leaves 20 grs. 

Boiling water J- pint. 

To stand for an hour ; then strain for use. 

He also gave croton oil to clear out the whole tract of the bow- 
els, and to act as a derivative. 

With these the writer would apply pounded ice, by means of 
an ox-bladder, to the spine, and perhaps give opiates. 

To publish what has been tried in vain would be useless. As 
draughts of cool air are known to excite the paroxysms, they are 
to be avoided ; and as to the wound, any splinters remaining in it 
must be extracted, and poultices assiduously applied to promote 
the formation of matter. 

Cramp 

may seize upon the arms or calves of the legs, and often at 
night. Where people are subject to these painful attacks, the 
author has prevented them by the following draught every night . 



HICCUP, OR SINGULTUS. 231 

No. 82. Bicarbonate of soda 30 grs. 

Compound spirits of ammonia (sal volatile) 30 drops. 

Water 1 oz. 

Syrup (if desired) 1 dr. 

But aperients must be given occasionally, and the diet looked 
to, so that there may be no undigested food in the stomach on 
going to bed. 

The following liniment may also be kept at hand by the bed- 
side : 

No. 83 Liniment of soap 6 oz. 

Tincture of opium » . . . . 1 or 2 oz. 

Rub with this, or rubbing with the bare hand will relieve. If in 
the leg, keep the heel down ; if in the arm, keep it straight. 

Hiccup, oe Singultus, 

though not dangerous, is often very troublesome, and may con- 
tinue for a considerable time. 

It depends on acid, or some irritating matter in the stomach, 
and relief will be obtained from the soda, etc., draught No. 83. 

Whooping Cough. (See Diseases of Children.) 

Breast Pang, or Angina Pectoris. 

An acute constrictory pain at the lower end of the breast- 
bone, rather on the left side and extending to left arm, accom- 
panied with great anxiety, palpitations at the heart, impeded 
breathing, and a sense of suffocation, mark the attack. 

The patient is attacked usually while walking, and especially 
while walking up an ascent, or facin'g particular winds. He stops 
immediately, and the distress may soon vanish. 

But after repeated attacks, slighter causes produce one, and 
the fits are more violent. 

At a more advanced stage the pulse becomes weak, intermits, 
or is irregular ; the countenance becomes pale ; there is constant 
cough, with an ejection of thick mucus; cold sweats; the sufierer 
can not lie down, and, ere long, death terminate? existence. 

Causes. — It is most common to studious and sedentary per- 
sons, and those of gouty or rheumatic habit, and after the age 
of fifty. As various functions and organic disorders of the heart 



232 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

eitlier accompany or cause this affection, all exertions, or sneez- 
ing, coughing, straining, or even speaking, will bring on a par- 
oxysm (fit). 

Treatment. — During the attack, distressing symptoms must be 
relieved. Stimulants should be given; as a glass of spirits and 
water, with fifty or sixty drops of tincture of opium in it, and 
repeated in twenty minutes or thereabouts; or this mixture, which 
the patient should always carry about him : 

No. 84. Compouiid spirits of sulphuric ether -J oz. 

Aromatic spirits of ammonia 1 dr. 

Tincture of opium 2 drs. 

Camphor mixture 7 oz. 

Mix. 

Two table-spoonfuls every half hour until relief ensues. 
Putting the feet into hot water, if feasible, directly, may re- 
lieve. Some recommend a mustard poultice. 
This liniment should always be at hand: 

No. 85. Soap liniment 5J- oz. 

Extract of belladonna J oz. 

Rub over the chest-bone about a table-spoonful of this lini- 
ment. During the intervals the sufferer must try to remove and 
avoid all the exciting and other causes. If there is fullness of 
habit, it must be reduced by a spare diet, and by avoiding every 
thing heating, or any thing exciting to the mind. 

Issues, setons, have been recommended. 

The digestion must be specially attended to ; for imperfect di- 
gestion, or too full a stomach, is very likely to bring on palpita- 
tation, and with it the fits. For flatulence give a soda draught, 
with sal volatile and one drop of hydrocyanic acid. 



FAiNTiNa, OR Syncope. 

The symptoms of complete syncope are not unlike those of 
sudden death, and in some few cases death does ensue. 

A person about to be attacked with fainting feels a great inward 
distress and faintness; the eyes become dim; there is a singing or 
buzzing in the egft's; the face and lips lose their color; the person 
becomes unconscious, cold perspiration follows; the person falls 
to the ground, and the respiration and pulse cease lor the time. 

Vomiting, convulsions, and a fit may terminate the attack. 



GIDDINESS OF HEAD— ASTHMA. 233 

Causes. — Mental emotions; blood-letting beyond tbe powers 
and strength; nervous irritability, debility, excessive pain, dis- 
eases of the heart. 

Treatment, — During the fit, which may persist for some min- 
utes, though usually it lasts only a few seconds, lay the head low, 
and keep it so. 

Apply stimulants to the nostrils. 

Administer a lavement of two drachms of pure water of am- 
monia in a pint of warm water. This has been successful in 
several cases. 

Sprinkling cold water over face and forehead. 

When the power of swallowing returns, the mixture No. 85, 
without the opium. 

To prevent the recurrence, if there is debihty, give bark, steel, 
tonics. 

Giddiness of Head — ^Vertigo 

is usually a symptom of other ailments, and must be treated as 
they are. It is often one of the first signs of a coming mischief 
in the head, and should not be neglected. 

Asthma. 

This disorder is marked by difficulty of breathing, coming on 
in its fits or paroxysms, usually commencing at night, during 
sleep. Great anxiety, stricture across the breast, palpitation, 
and a short, dry cough attend; the breathing becomes wheezing, 
laborious, gasping, and even sufi*ocative, while the countenance 
betrays anxiety. Fresh air is urgently sought, wherefore the 
patient rushes to the open window from the bed in which he can 
no longer lie recumbent. The surface is cool; face bloated and 
livid, or pale; the veins of head and neck are swollen; the pulse 
varies — may be intermitting, or too active and full, or natural. 
These symptoms continue a certain time, when the breathing 
becomes less laborious and anxious, and, toward morning, copious 
expectoration ensues, with relief. 

During the ensuing day the sufierer is pretty comfortable, but 
on the next night the fit returns, and this series of occurrences 
goes on for four or five days longer before it finally subsides. 
This is what is called humoral asthma; but there is a state of 



234 AMERICAN HOUSEHOLD BOOK OF MEDICINE". 

congestive asthma in whicli the expectoration is much less copious 
than in the former, and there is also a state of what is called dry- 
er spasmodic asthma, in which little or no expectoration is visible. 

The urine during a fit is usually, at its commencement^ pale or 
colorless and odorless; but after the fit has terminated, it is of 
a high color, and deposits a sediment. 

Causes. — Heart diseases, in which, of course, the asthma is 
merely symptomatic ; strong mental emotions ; hereditary tend- 
ency ; full meals; exposure to cold and moisture; certain efiluvia, 
as those from ipecacuan, hay, noxious vapors, any internal irrita- 
tion; rheumatism or gout. 

If asthma have once attacked, the fits are apt to return peri- 
odically, or when excited by certain atmospheric changes ; certain 
vapors; indigestion; obstructed perspiration; increase of the cir- 
culation from over-exertion. 

This disease is more susceptible of cure when it occurs in an 
early period of life, and in habits not much debilitated; also 
when it arises from accidental causes or from internal irritations, 
capable of being removed; but frequent fits, weak pulse, palpita- 
tions, and great impairment of the powers, with the threatening 
of other diseases, dropsy of the chest or limbs, denote an unfav- 
orable issue. 

Treatment. — The violence and duration of the paroxysms must 
be reduced. Small bleedings in full habits, or when there is 
great oppression at the chest, with full pulse, may be ordered; 
if pulse is small, dry cupping. The following assafetida clyster 
is very useful, speedily removing or moderating the distressing 
flatulence. 

No. 86. Sulphate of magnesia (Epsom salts) .... ^ oz. 

Olive-oil. . . . o 1 oz. 

Sugar , 1 oz. 

Tincture of assafetida 2 dr. 

Boiling water 12 or 16 oz. 

Dissolve the salts and sugar; add oil and the tincture when 
nearly cold. 

Expectorants, as tincture of squills, twenty drops, in an ether 
mixture. 

The Indian tobacco, lobelia inflata, in some cases, acts like a 
charm. From half a drachm to a drachm of the tincture, and the 
tincture is made by putting one ounce of the herb in half a pint 



CANINE MADNESS— HYDROPHOBIA. 235 

of alcohol. This, however, in some cases, acts like a poison, de- 
pressing the pulse and nervous energy ; so, if one dose do not 
give some relief, it had better not be repeated. 

In the debilitated, stimulants, strong coffee, ammonia, and ether, 
with opium, must be given. 

Inhaling ten drops of chloroform, but no more, unless ulider 
a medical man's eyes. A warm foot bath sometimes relieves. 

To relieve the distressing flatulence which often precedes the 
fit, Dr. Guy recommends alum 10 grains, ginger 5, and rhubarb 
3 or 4 grains, three or four times a day. 

Where oppressed breathing remains after the fit, the conges- 
tion should be removed by small doses of calomel, one grain, 
night and morning, with five grains of Dover's powder, for seven 
or eight days. Between the fits, take care of the diet and bowels; 
tonics, with alkalies and expectorants. 

The shower bath or cold water sponging has prevented fits. 
If there is any tenderness in the spine, rub it with stimulating 
liniments, or with the following lotion, which may bring out an 
eruption of yellow-headed, angry-looking pimples; then rub no 
more, but poultice : 

No. 87. Tartar emetic 40 gr. 

Rose or distilled water 2 oz 

Dissolve, and add of tincture of cantharides one ounce. 
The belladonna liniment (No. 86) may be useful, or belladonna 
plaster, either during or between the fits. 

Canine Madness. — Hydrophobia, oe Dread of Water. 

This terrible and fatal disease arises in from six weeks to eight- 
een months after a bite from a rabid animal, either dog, cat, fox, 
wolf, or jackal, and some say *sheep. The wound, it may be, has 
long healed, but a painful sensation arises in its site, and it often 
becomes red. The pain extends upward to the body ; the patient 
feels ill, then irritable, and feels a stiffness and pain about his 
neck and throat; then, unexpectedly, he finds he can not swallow 
any liquids, and every attempt to do so brings on a paroxysm of 
choking and sobbing most distressmg to behold. 

There is thirst; the saliva becomes thickened, is secreted in 
greater quantity than usual, and escapes from the mouth in a 
frothy state. This escape of saliva renders the breathing rather 



236 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

difficult, and increases the noisy gasping of tlie patient, giving 
rise to the idea of his barking like an animal. 

The patient is in an extremely irritable and excited state ; and 
owing to this, a current of air, the waving of a polished surface, 
and the noise of water falling or being poured from one vessel 
to another, brings on or increases the paroxysm. He makes no 
attempt to bite or hurt any one, and there is no delirium. 

Death may take place within twenty-four hours after the com- 
mencement of the specific symptoms ; but it commonly happens 
on the second or third day, though it may be postponed until the 
seventh or eighth. 

In some cases liquids can be swallowed before death. 

The symptoms of this disorder in the dog are, he becomes 
heavy, dull, and knows no longer those to whom he has been 
attached. He snaps at the air, drinks his own urine and dung, 
and swallows dirt, straw, and other articles within his reach. 
He roams about with back arched, and tail drooping; he runs 
or swims through water without difficulty. He will bite other 
animals if he comes near them, but will not go out of his way 
to do so. Other dogs avoid him; the voice is altered, the bark 
is between a bark and a howl, ending with a short howl. This 
howl is peculiar, and the dog dies in from six to eight days after 
the first attack. 

Rabies is as frequent in spring, autumn, and even winter, as 
in summer. M. Trolliet says that January (the coldest month) 
and August (the hottest in the year) are the very months in which 
the fewest examples are met with. 

Dr. Madden says that one in sixteen of those bitten have the 
constitutional disorder; but Scarpa deems this too low a calcu- 
lation. Out of one hundred and thirty-one bitten, only one 
manifested hydrophobia by the third day, and only three before 
the eighteenth. 

The period of greatest danger is between the fourth and sixth 
week. After this, the longer the period the less danger. From 
six weeks to three and a half months is the average period dur- 
ing which the poison may lie latent. Dr. Parry says the shortest 
period is twenty-three days, and the average period is forty-five 
days, so that we may place the minimum period at twenty-one 
days, the maximum at nine months. 

The saliva or mucus contains the poison; the poison, however, 



COLIC. 237 

ceases with the life of the animal. It must be introduced into 
the system by a bite, or by application of it to an abraded skin. 
But horses are said to have gone mad after eating straw on which 
rabid pigs have been lying, or the fluid may be deposited on the 
claws of animals, as cats, etc., and be so inoculated. 

We must distinguish hydrophobia from tetanus. In th^ for- 
mer the slightest draught of air, a sudden touch, or smallest drop, 
or even the sight of water, bring on the choking spasms ; not so 
in tetanus. 

Treatment is very unsatisfactory ; prevention is every thing. 
But, fortunately, few who are bitten become affected, owing to 
the saliva being left in the clothes above the bite, or to the poison 
not being intense. 

Let a surgeon take out the bitten part. If none be at hand, 
heat a wire to a great or even a white heat, and cauterize the 
part ; and some courageous persons have cut a bit of stick the 
size of the bite, put it into the wound, and cut out all round it. 

Sucking or a cupping-glass to the wound may prevent. 

Mr. Youatt trusts to the lunar caustic (nitrate of silver), which 
is made like a pencil. Put this wetted to the bottom of the wound ; 
then poultice. He has thus operated on and saved four hundred 
persons, not losing a single case. 

Dropping strong nitric acid or caustic liquor of ammonia into 
the wound may be practiced if no lunar caustic be at hand ; but 
the local application should be made as soon as possible after the 
bite has been received. 

As to preventive drinks or specifics, numbers have been tried 
in vain — guaco, the Ormskirk powder, etc. They are only, use- 
ful in filling the pockets of the quacks. 



Colic 

is a painful distension of the lower region of the belly, accom- 
panied by a twisting pain around the navel, by vomiting, costive- 
ness, and spasmodic contractions of the muscles of the belly. 

This disorder is divided into several species. 

1st. The spasmodic form. 

2d. That arising from costiveness, or from acrid matter in the 
bowels. 

3d. That from lead poison. 



238 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

4th. That in newlj-born children. 

5th. That from calculi, or concretions in the bowels. 

6th. That from worms. 

It is highly important to distinguish colic from inflammation of 
the bowels, which latter disease may prove fatal, and in which most 
active treatment is requisite. In inflammation of the bellj there 
is fever, with tenderness and pain, increased by pressure, and by 
the breathing even. In colic there is no fever, and pressure will 
give ease, the patient often lying on his belly to obtain more ease. 
The pain, too, in colic comes on in fits of very violent pain, which 
succeed intervals of ease. However, we must not forget that long- 
continued colic will now and then bring on inflammation. 

Treatment. — Should the sufi'erer be young and vigorous, some 
blood may be taken or leashes applied. 

If much nausea and bilious vomiting attend, give the saline 
draughts while in efi"ervescence, adding to each twenty to thirty 
drops of tincture of opium. 

When the sickness is abated, give blue pill four grains, calo- 
mel two grains, and compound extract of colocynth four grains, 
in two pills. In about three or four hours give the salts and 
senna mixture ; but in all cases administer lavements or enemas. 
When much flatulence attends, nothing succeeds better than the 
assafetida clyster, thus prepared: 

Assafeiida Clyster. 

No. 88. Take of prepared assafetida 1 dr. 

Decoction of barley J- pt. 

Mix. 

Throw the fluid up as high as feasible, but gently. Give car- 
minatives. 

No. 89. Camphor 5 grs. 

Spirits of sulphuric ether 30 drops. 

Tincture of opium 20 to 40 drops. 

Compound tincture of cardamoms 1 dr. 

Rub together and mix, then add water one ounce. Or this : 

No. 90. Compound tincture of cardamoms. 1 drachm. 

Tincture of opium 30 drops. 

Peppermint-water 3 table-spoonfuls. 

Mix. 

Repeat this according as the pain seems to demand. 



ILIAC PASSION. 239 

The writer recommends flatulent persons to have these drops 
always at hand : 

Anti -flatulence drops. 

No. 91. Liquor of potash. \ 

Strongest (saturated) tincture of ginger. >- each 1 oz. 
Compound spirits of ammonia. J 

Mix, and add of cyanide of potassum IJ grains. Keep the bottle 
cool, well-corked, and covered from the light, and before using 
shake the bottle well. 

The dose is sixty drops in an ounce of water, or of peppermint 
or aniseed water. 

The warm bath or opium poultice, or hot flannels and fomen- 
tations will relieve. The diet must be looked to between the 
attacks, so that as little irritating matter as possible may have 
to pass through the bowels. 

But there is a kind of colic, arisiDg from concretions, or irri- 
tating matters in the bowels, or from one portion of the bowel 
slipping into another lower portion, and it has been called the 

Iliac Passion. 

This arises in many cases from mechanical obstruction of the 
bowel, and the symptoms, from commencing with those of colic, 
soon assume those of inflammation of the bowel, the inflamma- 
tion being a consequence of the obstruction. 

Symptoms. — Costiveness. Aperients are taken without efi'ect, 
and when repeated, griping, nausea, and sickness follow. Clysters 
are given; some hardened masses are brought away without re- 
lief; then fever symptoms set in, with vomiting of matters, that 
at last look as if they consisted of the excrementitious matter 
itself. 

Prostration, with hiccup, cold sweats, and failing pulse, precede 
death. In the case of intestinal concretions, they first obstruct, 
mechanically, the passage through the bowel; then inflammation 
supervenes, and mortification. ^ 

The symptoms are much the same as those of ileus, only that, 
in emaciated persons, the concretion, when it is of a large size, 
may be felt by placing the patient on his back, with knees bent. 

Otherwise, we have no other evidence of their existence than 
after they have passed away by stool. There is a constant desire 



240 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

to sit on the water-closet; yet, witli all the straining, nothing is 
expelled until the concretion arrives at the lower part of the 
lower bowel, where it stirs up great disturbance and the most 
furious straining. It can then be taken away, being within reach, 
by a pair of forceps or pliers, or it is at length forced away by 
the natural efforts. 

These concretions are caused to form, by sedentary occupa- 
tions, inactivity, indolence ; by a weak state of the digestive pow- 
ers ; by a large use of magnesia and calcareous earths ; by swal- 
lowing various other things — the husk and beard of the oat, bones, 
cherry-stones, or seeds. 

Dr. Copland, in a well-written article on Intestinal Concretions, 
tells us of cases which arose out of either depraved appetite or 
bad habit, such as that of chewing the ends of thread used in 
sewing, and which have formed a firm felt with the. mucus of the 
boAvels and other matters. In another case, the young lady had 
been in the habit, from the age of thirteen or fourteen, of chew- 
ing, and sometimes swallowing, portions of the gray paper with 
which she curled her hair. After much suffering, about twelve 
concretions, from the size of a filbert to that of a walnut, were 
evacuated. 

Treatment. — In such cases, purgatives and clysters are nearly 
all we can do, with effervescing draughts to allay vomiting; but, 
first, always make sure, by proper examination, that there is no 
hernia or rupture. 

The writer has had several cases of obstinate constipation in 
colic, and after trying other remedies, he has succeeded in elic- 
iting motions by the tobacco clyster; only we dare not administer 
tobacco if there is much prostration; but assuredly tobacco pow- 
erfully relaxes the bowels; still, care is indispensable, and it is 
almost too dangerous a remedy for any one but a medical man 
to use. 

Those who are liable to cohc should be very cautious as to what 
they eat ; for the author was called to a groom, within a few hours 
of his dea|h, who had been subject to colic, and who was seized 
with colicky pains, after eating two golden pippins. 

The moribund man received no benefit from any thing, though 
pain had suddenly left him, from mortification having set in. 

After death, a portion of the large bowel was found black and 
mortified, but contracted in diameter ; and in that contracted part 



COLIC FROM WORMS. 241 

were discovered several of the apple-seeds, and of thin, sharp- 
edged, stiff capsules of the core of the apple. Yet this slight irri- 
tation Tvas sufficient, in one predisposed, to set up an action that 
unfortunately terminated in death. 



Colic from Worms. 

It would seem that in the economy of nature every species of 
animal is liable to be infested by its peculiar parasite or para- 
sites, which are developed in and protected by its various text- 
ures, and draw their sustenance from its juices ; and man him- 
self is subject to a greater number of parasites than any other 
living being. 

In some instances, these parasites have their own peculiar para- 
sites, as in the largest ichneumon of the tiger-moth. This ich- 
neumon seeks, among lettuce, nettles, currant bushes, strawberry 
beds, etc., for its object of attack; and when it has found a cat- 
erpillar, "it seizes it behind its head with its jaws. At this ope- 
ration," says Mr. Newman {History of Insects), "the caterpillar 
loosens its hold of the plant on which it was feeding, rolls itself 
suddenly into a ring, erects its bristles as stiffly as possible, and 
falls to the ground. If the fall is great and among twigs, the 
ichneumon is sometimes dislodged ; but this rarely happens. 

" The female ichneumon has three bristles at its tail ; and the 
middle one of these appears to be a tube for conveying its eggs 
into the body of the caterpillar, and is called an ovipositor. The 
outer ones seem to serve as protectors to this ovipositor, and not 
to be used for piercing the caterpillar. When the caterpillar can 
fall no further, it frequently unfolds itself, and writhes about to 
dislodge its enemy. But its struggles are useless ; the ichneumon 
elevates its body into a kind of arch, bending the ovipositor 
formed beneath it nearly to its mouth. It then steadies the ovi- 
positor by its hind legs, and with a slight jerk drives it into the 
skin of the caterpillar, behind the head. The egg is instantly 
deposited, the ovipositor withdrawn, and the ichneumon flies 
away. The caterpillar then remounts the plant, begins to feed 
eagerly, and there seems to be no difference in its growth after- 
ward. 

"The ichneumon's egg is soon hatched, and begins eating that 
part of the caterpillar which is immediately in its neighborhood, 
16 



242 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

and continues its course toward the tail, devouring all the fat and 
muscular parts not essential to life," avoiding, by a wondrous in- 
stinct, those parts essential to life, as though it was aware that 
the cessation of life in the caterpillar would insure its ow^n death, 
as it could not subsist on the putrefying carcass. 

^'The caterpillar of the tiger-moth is preyed on in a similar 
manner by the maggot of a two-winged fly; and this maggot, 
while thus devouring the interior of the caterpillar, is itself a 
prey to a minute kind of ichneumon, twenty of which sometimes 
feed in the maggot of a single fly." 

The various worms that infest the human frame are these, in 
the small intestines (bowels) : 

The Round worm, 

Taenia, or Tape-worm, 
Second kind of Tape-worm. 

Another kind infests the large intestines. The rectum or lower 
bowel, the urinary bladder, the gall bladder, the kidney, the eye, 
the liver, the spleen, the ovary, the bronchial glands, the sub- 
stance of muscle, the brain, and the cellular texture, all have 
their respective parasites. 

But we are interested chiefly in the flat worms, round worms, 
and thread worms. 

Symptoms are those which proceed from the irritation of worms 
in general, and those which are caused by each peculiar kind. 

From worms infesting the bow^els arise pain in the belly, like 
that of colic, twisting round the navel ; though sometimes pain is 
absent, as is usual in cases of tape-worm, which worm is so soft 
in its texture as to give rise to no definite sensations, except such 
as might arise from the length and bulk of the worm interfering 
with the movements of the intestines. The round worm causes 
pain more frequently, probably from its firmer texture and sharp- 
ened extremities. 

These pains, gnawing sensations, etc., may not proceed from 
worms, and we can not be sure till we have seen some worms, or 
fragments of them, thrown up by vomiting or ejected by stool. 

The evacuations are mostly unnatural in quantity or quality, 
and there is either costiveness or looseness, or these states may 
alternate. The stools are of mucous character, or they may be 
ofi'ensive ; the belly is swelled, and there is much windy disten- 



TAPE- WORM. 243 

Bion ; tlie tongue is loaded, the breath heavy, and smells offen- 
sively. 

Irritation about the Anus. — The system may sympathize with 
this state, and there may be headache, giddiness, ringing in the 
ears, disturbed sleep, picking of the nose, grinding of the teeth, 
dilated pupils, convulsive affections. 

Tape-worm. 

The common tape-worm of this country is generally from five to 
ten feet in length, and in breadth from the fourth part of a line 
at its anterior part to three or four lines at its posterior part, 
where it again diminishes. 

The head is small, and somewhat flattened. 

*' These worms are rarely passed entire," says Dr. Farre, from 
whose complete account I am extracting; single joints often 
come away, especially in children, or portions of two or three 
feet in length are voided; but it is very rarely that the portion 
on which the head is situated is thus passed. There appears to 
be no limit to which the worm may grow. If we are to credit 
the older authors, many hundred feet have been attained; but 
there appears to be no reason to doubt that worms measuring 
sixty feet are of occasional occurrence. As many as eighteen or 
twenty worms have been passed in the course of a few days ; but 
frequently they occur singly. 

"The first symptom giving evidence of the existence of this 
worm is, the passage of a joint or two from the bowels; but there 
may be the usual signs already described." 

The constitution is more or less affected, sooner or later^ in 
these attacks, though portions may be passed for several years. 

Treatment, — Turpentine, when it can be taken, is decidedly the 
best remedy here. It is best given combined with castor-oil; 
about three-quarters of an ounce of each should be given, two or 
three hours after a full meal, rather than on an empty stomach; 
and broths and mucilaginous decoctions must be freely taken; 
while, to avoid sickness, the piatient should remain at rest. 

These doses should be repeated, with intervals of a day or two ; 
but with every precaution. Symptoms of nausea and vomiting, 
and almost alarming intoxication, ensue, or a "general chill and 
paleness, and sometimes a tendency to sleep." 



244 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

These states will, however, go off after a time. But if turpen- 
tine can not be borne, then give the pomegranate root in decoc- 
tion ; or, to a child of nine years of age, twenty grains of the 
dried bark were given every hour for five hours, when, forty min- 
utes after the last dose, a living taenia was expelled. 

Decoction of Pomegranate Root. 

No. 92. Of the fresh bark , 2 oz. 

Boiling water 1 J oz. 

Boil down to three-quarters of a pint ; two ounces of this to be 
given every half hour for four doses. But this bark causes sick-^ 
ness, giddiness, and trembling sometimes ; it, however^ acts like a 
poison on the taenia. 

In Abyssinia, a native plant called the kousso is the remedy 
generally used. This plant is a bray era anthelmintic a, and the 
way to use it is this : 

No. 93. Of the powdered flowers ^ oz. 

Infuse, for a quarter of an hour in lukewarm water, ten ounces, 
for a grown-up person. A little lemon-juice is to be swallowed, 
and then, stirring up the infusion, swallow the whole, both fluid 
and solid, at two or three draughts, being washed down with cold 
water and lemon-juice. To promote its operation, tea, without 
sugar or milk, may be taken. 

In three or four hours, if the bowels have not operated, a dose 
of castor-oil or a saline purgative should be given. For children 
a much smaller dose must be given. No very evident symptoms 
follow the kousso thus taken ; but in some cases slight nausea and 
thirst, or slight vomiting may occur. 

This kousso expels the tape-worm ; but the worm has recurred 
in some cases. 

In February, 1854, Dr. Budd recommended strongly the oil of 
the male fern in cases of taenia; it does not always cause the 
evacuation of the head of the worm, but kousso also fails in like 
manner. 

He begins with three grains of oalomel and four of scammony, 
the first night and morning; and at four A. M., the next morning, 
,castor-oil one ounce; then two hours afterward give two drachms 
of the oil of male fern, mixed up in a sufiicient quantity of mu- 
cilage of gum arable. The patient was forty years old. All the 



THE ROUND WORM. • 245 

joints, except the head, came away about nine the next morning. 
The medicine made him giddy and weak; perhaps repeated doses 
would succeed. The larger the joints are, the further from the 
head. There are two kinds of tape-worms, one common in this 
country, the other in Switzerland, Russia, Poland, and part of 
France; but the treatment is the same for both. 

Tonic medicines, bitter infusions, etc., will aid in giving tone 
to the bowels. Purgatives must be given occasionally to remove 
the mucus from the bowels, which mucus may be a nest for the 
worm. Alston recommends zinc filings, giving first a purgative; 
then an ounce of the filings are to be taken in four ounces of 
treacle. 

The Round Worm. ^ 

This is often met with in badly fed children. It exists in the 
small intestines, but it sometimes crawls upward to the mouth. 
This worm is from five to eight or ten inches long; it is round 
and smooth, of a white or yellowish color. It looks like a. com- 
mon earth-worm in some respects, but the mouth, which is marked 
with three small prominences, distinguishes it. 

These worms may exist alone, or there may be a great many 
in the bowels, and the mucus is much increased. Dr. Hooper tells 
us of more than two hundred worms having been voided in a single 
week. 

Dr. Heberden states the symptoms to be pains in the head, gid- 
diness, sudden waking from sleep, and unpleasant dreams, fever, 
thirst, paleness of face, bad breath, picking of the nose, difficult 
breathing, great craving for food ; the patient gets thinner and 
thinner, bearing down and itching at fundament, slimy motions, 
swelled belly, grinding of the teeth during sleep. In long stand- 
ing cases, a thick, nasty-looking eruption appears on the face, 
sometimes forming one entire crust over it. 

Treatment. — Active purgatives. 

No. 94. Calomel 2 or even 5 grs. 

Powdered jalap 10 grs. 

" ginger 4 grs. 

Rhubarb may be given instead of the jalap. 

To work off these powders, castor-oil or infusion of senna, one 
ounce and a half; and tincture of senna and of jalap, of each one 
drachm. 



246 AMERICAN HOUSEHOLD BOOK OE MEDICINE. 

After due action of the bowels, the sulphate of iron, or the tinc- 
ture of the muriate of iron, is efficacious. 

Of the sulphate of iron, one grain may be given three times a 
day, made up into a pill. For children, the tartarized iron. 

Drs. Evanson and Maunsell strongly recommend this electuary : 

No. 95. Powdered jalap, crystals of tartar, carbo- 
nate of iron, of each 1 oz. 

Powdered ginger 30 grs. 

Half a tea-spoonful three times a day, or treacle may be added, 
so as to make an electuary. 

The writer has found great benefit, in cases of round worm, from 
giving oil of turpentine and castor-oil mixed, as was recommended 
in tape-worm. 

Bremser gives the following electuary for three or four nights, 
and says he has seldom occasion to repeat : 

No. 96. The seed of the Santonicum or worm seed, 
and the seed of the tansy (Tanacetum), 

both bruised, each J- oz. 

Powdered valerian 2 dr. 

" jalap 90 grs. 

Sulphate of potash J oz. 

Oxymel of squills, enough to make an electuary. 

A tea-spoonful every night and morning for four days, or until 
an ample purgative effect is produced. 

If this electuary be too disagreeable to take, the whole of the 
above ingredients, except the oxymel, can be made into a powder, 
and then into pills. 

Sometimes we must interpose an active purgative. 

The Thkead-worm. 

This is the smallest worm which infests man, the males of which 
are about two lines in length, the females about five; their color 
is white. 

These occur often in large numbers, and masses of them are 
sometimes expelled, enveloped in mucus, or rolled into a ball, and 
they are now and then found in the neighboring passages, of both 
male and female. Their chosen seat is the lowest bowel. 

The symptoms peculiar to these irritating worms are a great, 
almost intolerable, itching of the anus (fundament), coming on to- 
ward evening, and increased by warmth and exercise. 



THE THREAD-WORM. 247 

Besides this irritation, there is usually some dull pain in the part 
which is rubbed by the sufferer, until hard small swellings form, 
in consequence of the friction, which swellings might give an idea 
of piles, on superficial examination. 

There are frequent calls to relieve the bowels, and slimy mu- 
cous evacuations are passed, with perhaps some blood in theTn. 

The depraved appetite, the weak digestion, pains in the head and 
stomach, with giddiness, gripings, sickness, picking of nose, foul 
breath, cough, and dreaming, disturbed sleep, may, one or more, 
attend cases of thread worm, as of round worm. The peculiar 
characteristics are the local itching and uneasiness, which is very 
great, owing, it is supposed, to the great activity and restlessness 
of the worm in leaping about. 

Treatment of Thread-worm, — The difficulty in managing these 
cases arises from their multiplying so fast, and from their position, 
from which it is not easy to dislodge them. Even when we have 
succeeded in nearly clearing the bowel of them, the few that are 
left multiply with amazing rapidity. Our objects in treatment are 
to promote the expulsion of the worms, and to remove the habit 
of body, or the causes, which favor their formation. 

The local treatment is the more important part of treatment; 
and, first, there should be no rubbing to relieve pain and itching, 
which may be better done by applying cold cloths to the part, and 
by lavements of olive oil, or olive oil with a few drops of creosote 
added, may be used as a liniment externally. 

But lavements of simple infusion of quassia are effective, says 
Dr. Schultz, one drachm of quassia shavings to one or two ounces 
of water. 

Dr. Darwall ordered injections of the tincture of muriated iron, 
half an ounce; in water, half a pint. He said: "There are few 
cases so obstinate that this will not suffice to overcome." Or of 
sulphate of iron, two to five grains ; cold water, four to six ounces — 
an excellent injection. 

Lime water, as an injection, is also useful; to it one drachm 
of tincture of aloes may be added. 

To improve the general habit, purgatives, such as one or two 
grains of calomel, with double the quantity of scammony, will dis- 
lodge the worms, and bring away a great deal of mucus, thus de- 
priving the worms of their support. 

Jalap, too, is a good purgative. 



248 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Mechanical means employed to bring away these worms are^ 
the introduction of a candle, or a piece of lard or pork, with string 
attached, which will bring away many. 

Some introduce the finger, or a scoop. 

Tonics must be persevered in — the tonic infusions, the prepa- 
rations of iron. 

Occasional purgatives must not be forgotten. 

The diet must be nutritious, but plain, while flatulent vegeta- 
bles must be avoided in every instance. 

Guinea Worm 

infests the cellular structure under the skin, and it is usually met 
with in the feet and legs, but occasionally in other parts. Its 
length varies from that of six inches to twelve feet, and its di- 
ameter, which is the same throughout or nearly so, is rather more 
than half a line. The color varies from whitish to dark brown. 
The outside is marked by minute circles. It is viviparous; that 
is, brings forth its young alive. It seems that it is capable of 
changing, though slowly, the positions which it occupies in the 
cellular membrane, and its final expulsion is effected by a process 
of local inflammation, which is followed by the formation of pus 
or matter. 

It mostly is single, though in some places as many as twelve, 
and even fifty, have been found in the same individual. This 
parasite is peculiar to warm climates, abounding in Upper Egypt, 
Arabia, Abyssinia, and Guinea. 

The general opinion is, that it is introduced into the body through 
water, as while bathing ; in corroboration of which opinion we find 
that the water-carriers in India suffer from its fixing in the skin 
of their backs, which is in contact with the leathern water-bottle. 

Symptoms. — Uneasiness and itching in the site occupied by the 
worm, a slight cord-like elevation indicating its seat; a vesicle (lit- 
tle bladder), or a little spot of yellow fluid (pustule) forms, which 
at length gives exit to the head of the worm. The constitution 
sympathizes, and there is more or less of febrile irritation. 

Treatment. — Never break the worm, for then abscesses would 
form, with acute inflammation, and cause much trouble. If the 
worm is short, it may sometimes be extracted at once, but great 
care is required in pulling on the worm; the moment resistance 



COLIC FROM LEAD. 249 

is felt, stop all pulling; then, to prevent the protruded portion from 
going back into the skin, wind it round a piece of sticking-plaster 
or a bit of stick; keep this in contact with the part, and cover 
with light dressing. 

The natives often cure at once, by guessing where the center of 
the worm is situated, cutting down on it, and extracting botli*ends. 

The external parasites of man comprise the louse, the itch in- 
sect, and the chigoe. 

Of the louse, there are four kinds : that infesting the head, the 
crab louse on the pubiSj the body louse, and the louse of the eye- 
lash. 

These are easily removed by cleanliness, shaving off the hair, 
and always by mercurial preparations ; as white precipitate in 
powder, or mercurial ointment, well rubbed in. 

The itch insect is cured by sulphur, which poisons it. 

The chigoe is peculiar to warm climates ; it penetrates the skin 
of the toe mostly, and lodges its eggs to the number of sixty. 
These eggs are hatched after a time, and cause much irritation 
and annoyance. 

The eggs lie in a little bag, called a cyst; and this cyst must 
be extracted entire, for, if broken, an ulcerated sore forms, and 
proves very troublesome. 

Colic from Lead. 

The symptoms are those of ordinary colic, perhaps more vio- 
lent; the whole belly is tense, and there are irregular knots or 
lumps from the contraction of the muscles; the spasm is so vio- 
lent that even a clyster pipe can not be introduced, such is the 
. spasmodic resistance ; the restlessness is constant, and there is a 
frequent vomiting of an acid or onion-smelling matter, especially 
after taking food. 

If no amendment be procured, the symptoms become violent, 
the costiveness obstinate, and a dangerous inflammation is set up 
in the bowels, which terminates in mortification. 

Generally, the first attacks are recovered from, the constipation 
ceases, and ease- follows, until after a longer or shorter period 
another attack ensues; though even first attacks may be followed 
by pains in the head and limbs, or by cramps, or even epilepsy 
and coma. 



250 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

At last, after a certain number of attacks, the sufferer finds he 
has lost the use of one or both his hands; the wrists drop, and 
■when the arms are stretched out, the hands hang dangling by their 
own weight, nor can the patient raise them by any effort of his 
will. 

The affected muscles waste, especially those of the ball of the 
thumb. Recovery is still possible, but if the person continues to 
expose himself to the cause, the poison accumulates in the body, 
he becomes a cripple, falls into a bad habit of body, and dies. 

A very peculiar mark of lead being in the system has, within 
the last few years, been discovered by Dr. Burton. It is a blue 
or purplish hue, running along the edges of the gums, where 
they meet the teeth. A knowledge of this fact, if lead turn out 
to be the only metal which produces this blue line, may be of 
practical use in various ways. 

The coloring material is probably sulphuret of lead, or a sim- 
ilar salt, which is thus formed in the tartar or incrustation around 
the teeth. The tartar is porous, and admits into its substance 
fluids charged with animal matter, which would furnish sulphu- 
reted hydrogen, and this would form, with the lead present, a sul- 
phuret, giving the characteristic ; certain it is that the blue color 
existed wherever there was a tartareous incrustation of the teeth. 

Treatment of Lead Colic. — The great object is to obtain action 
of the bowels ; afterward, to treat the palsy, and prevent returns 
of colic. 

Bleed, if the pulse be full, the pain in the belly be increased 
on pressure, and signs of fever are coming on. 

Then the warm bath, and a lavement of warm water while in 
the bath. 

Diligent frictions, with some stimulating liniment, or linen 
wrung out of hot turpentine may be laid on. 

Give calomel, ten grains, and two of opium. Then a full dose 
of castor-oil ; or, if castor-oil do not act, give an ounce of castor- 
oil and a drop or two of croton-oil added to it ; and we may re- 
peat this alternation of calomel and opium with the oils. 

After free motions, recovery soon ensues. 

Thus advises Dr. T. Watson, and the practice seems to be the 
best possible. But Dr. Gendrin, of Paris, cures with sulphuric 
acid, forty-four drops to a pint of water, and two or three pints 
are drank every day. It is sometimes vomited at first, but it is 



VOMITINa FROM SEA-SICKNESS. 251 

retained in a few days. The pains diminish after the first, sec- 
ond, or third day, and as they diminish, the bowels act naturally. 
No other medicines are given ; no lavements, nothing but a daily 
sulphur bath ordered. At the commencement, the sulphur in the 
bath combines with the lead in the body, and a black insoluble 
sulphate or sulphuret is formed on the skin; and this in^l-usta- 
tion on the skin is so great that those who go into the bath with 
white skins come out with black, like negroes. The patients are 
to brush away this incrustation with a brush, and soft soap half 
a pound. These baths were repeated till the skin remained of the 
same color on coming out from, as on going into, the baths. 

The preventive system is of importance with all who are ex- 
posed to the causes of lead-poisoning. 

In the first place, the workmen should drink daily one or two 
glasses of the preceding sulphuric acid lemonade, and Mr. E. Ben- 
son gives to his workmen the following sulphuric beer instead of 
the lemonade : 

No. 97. Treacle 15 pints. 

Bruised ginger J R). 

Water 12 gals. 

Yeast 1 quart. 

Bicarbonate of soda 1 J oz. 

Sulphuric acid 1^ oz. by weight. 

Boil the ginger in two gallons of the water ; then add the treacle 
and the remainder of the water, hot. When nearly cold, pour 
the whole into a cask, and add the yeast to ferment. The fer- 
ment nearly over, add the acid, previously diluted in eight times 
its weight of water ; add the soda dissolved in one quart of water ; 
close up the cask, and in four days all will be fit for use. This 
soon spoils. 

Secondly, cleanliness, washing head, hands, face, etc., and bath- 
ing to keep the body clean ; clothes of linen, not woolen, and they 
should be often washed — all clothes left in the workshop. 

Thirdly, cleanse hands and lips before eating; and lastly, it 
would be well to guard the air-passages by mask or respirator. 

YoMiTma FROM Sea-sickness. 

Vomiting is a spinal act, and may be excited through the 
agency of several difi'erent nerves, as in the vomiting caused by 
irritating the fauces und palate. 



252 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Secondly, in that caused by an emetic, or by gall-stones, or by 
stones in tlie kidneys ; and, thirdly, in the vomiting of early preg- 
nancy. 

In this state of sea-sickness the greatest relief is obtained by 
remaining perfectly quiet and motionless, in the recumbent pos- 
ture, on deck, or exposed to the fresh air; and the best remedy 
is to take a small tea-spoonful of Cayenne pepper in some liquid 
sweetened. This directly restores animation, and causes the seem- 
ingly stagnant blood to circulate in its proper course. 

Cholera 

may be divided into English cholera, or mucous gastro enterite, 
and into malignant or Asiatic cholera. 

English cholera commences with nausea, pain, and distension of 
the belly, with frequent vomiting and purging of bilious matter, 
which at last becomes mucous. Tongue furred, pulse frequent 
and small, thirst. Death is said to have taken place in twenty- 
four hours, with hiccup, cold sweats, cramps, and convulsions. 
The skin assumes a livid hue under great prostration. 

Causes. — Heat, transitions of temperature ; autumn ; improper 
diet ; certain fruits, as cucumbers, melons, etc. ; irritant poisons, 
active or violent purgatives. 

Treatments — If this disease do not kill before the third or fourth 
day, recovery is to be expected ; but the more violent the cramps, 
and the greater the prostration, the worse for the patient. 

Soothe irritability of the stomach; opium is the sheet-anchor, 
indeed the only remedy. Give sixty to one hundred drops of 
tincture of opium ; and nothing is to be taken into the stomach for 
half an hour afterward, in order that the medicine may not be 
rejected by vomiting. 

A lavement of laudanum, forty drops in warm water. If the 
drops are thrown up, repeat thirty to forty drops every fifteen 
minutes until its influence on the system is fully obtained. A 
large mustard poultice over pit of stomach, or else reddening lini- 
ments ; hot turpentine cloths may be applied ; only the smell often 
provokes the vomiting. 

The irritability may thus be quieted in sixty to eighty minutes ; 
and Dr. Eberle says, if from six tt> eight grains of opium can be 
introduced and retained in the stomach for fifteen to twenty min- 



ASIATIC OR MALIGNANT CHOLERA. 253 

utes, we may calculate with certainty on tlie speedy subsidence of 
the disease. 

But if it be rejected by vomiting, we must apply it externally, 
thus : Mix two parts of nitric acid with one of water, and with this 
liquid wet a sponge, and apply it over the region of the stomach. 
As soon as pain is felt, wash the part with a solution of cajrbon- 
ate of potash. The cuticle may now be easily detached, so as to 
leave the underlying true skin exposed and raw. Upon this sur- 
face sprinkle from one to two grains of acetate or muriate of mor- 
phia, and cover with a piece of linen, on which simple cerate has 
been spread. In this way we combine counter-irritation and an 
anodyne, or soothing remedy. 

L-ritability being a little subdued, give calomel, one grain every 
three or four hours, to act on the liver ; but opium must be added 
if there is much vomiting. 

For the cramps, rub with this : 

No. 98. Soap liniment 8 oz. 

Cyanuret of potash 20 grs. 

Tincture of capsicum 1 or 2 oz. 

The warm bath is useful. 

If there is great prostration, give 

No. 99. Sulphuric ether 1 oz. 

Camphor ...» 1 dr. 

' A tea-spoonful of this every half hour, until the cold, clammy 
sweats and the coldness of the body, of the legs especially, are 
giving way. Then give less frequently, until the scarcely percep- 
tible pulse has at length become fuller and more indicative of 
power. 

Mild mucilaginous fluids may be given Avarm, only observing the 
direction, after the first dose of opium. 

So barley-water, freely given, will be serviceable. 

After the attacks, animal broths, etc., and gentle tonics, as in 
convalescence from other complaints. 

Asiatic or Malignant Cholera. 

Asiatic Cholera is a disease which, according to the best infor- 
mation we have, originated in August, 1817, at the city of Jessore, 
about eighty or one hundred miles north-east of Calcutta, and 
thence spread rapidly over the peninsula of India ; but did not, 



254 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

however, leave that hot country for more temperate portions of 
the globe until the year 1829. It then advanced north, being 
most likely carried by a caravan to Orenburg, a city of Russia. 
Thence it followed the avenues of travel, until eventually it arrived 
in America, in June, 1832. This visitation began at Quebec, and 
thence rapidly spread over m'any parts of the United States— ap- 
peared at different points for two or three years, and then disap- 
peared. 

After a repose, or disappearance, for some years, this same dis- 
ease again visited Europe, coming from the same part of the globe 
where it originated, and diffused itself over Europe, and again re- 
visited the United States. It arrived in this country, at New Or- 
leans, on the 8th of December, 1848, and about the same time at 
Staten Island, near New York ; and on the 25th of that month, it 
was brought by a steamboat to Cincinnati. It soon visited other 
parts of the country, and eventually swept over a large portion of 
North America. About the close of the year 1855, it altogether 
disappeared, after having caused most dreadful mortalities at many 
points on this continent. It is evident, from these observations of 
the manner which this disease has hitherto swept over the earth, 
that we may again have to meet it, and that we may look for a 
revisitation within a short period. 

The various degrees of intensity which accompany this dreadful 
malady, in different countries and climates, render it necessary to 
give our views of the proper methods of treatment which ought to 
be adopted should the United States again be the theater of its 
ravages. We will, therefore, consider it as we saw it in its visita- 
tions, beginning in 1832 and late in 1848, and the proper methods 
of treatment. 

From the observations which the writer made during the two 
great invasions of the cholera, he came to the conclusion that the 
disease could be better understood by dividing it into four stages. 
First, the diarrheal ; second, that in which vomiting and purging 
occurs ; third, the stage of collapse, where there is a loss of pulse, 
and mostly a cessation of both purging and vomiting; the fourth 
stage, or that of reaction, which follows collapse, and which is 
characterized by the reestablishment of all the secretions. 

During the first stage, diarrhea was not always present, though 
it was, without doubt, a general symptom. Where it did not occur, 
there was loss of appetite, noise in the head, giddiness, or pain of 



ASIATIC OR MALIGN AXT CHOLEHA. 255 

the head ; tongue slightly coated, with occasional cramps of the 
muscles of the feet or legs, and often pain in the loins. After all 
or some of these symptoms had continued during a few hours, or 
several days, they exploded into either the symptoms accompany- 
ing the second stage, or into dysentery — frequently the latter. 

More frequently there was diarrhea, accompanied by a sejase of 
numbness at the epigastrium or pit of the stomach, and the other 
symptoms above enumerated. These were generally, if not always, 
accompanied by a scanty secretion of urine. These symptoms 
continued often for days before rice-Avater evacuations made their 
appearance. We saw one collapsed case that had been preceded 
by many of the above symptoms, such as diarrhea, cramps — espe- 
cially at night — loss of appetite, and depression of spirits, for a 
period of three months. This patient died from collapse. 

It was often diflBcult to arrive at a correct diagnosis between 
common diarrhea and the first stage of cholera. Our own conclu- 
sions were based upon the following inquiries : 1. Had the patient 
been much exposed to cholera influence ? 2. Were the evacua- 
tions lighter colored than in common diarrhea? 3. Were they 
more copious and debilitating? and, 4. Did they occur from any 
cause independent of diet and sudden exposure ? If these inter- 
rogations were answered in the affirmative, we felt pretty certain 
that the patient had cholera in its premonitory form, and that it 
was liable to explode into the second stage at any moment. This 
stage of diarrhea was called by the quacks cholerine ; and they 
often claimed the credit of curing cholera, when, in reality, their 
cases were nothing more than common irregularities of the bowels. 
We could point out not a few instances where persons were pro- 
nounced to have had cholera several times. A delicate lady told 
us that she had had the disease twice in 1850. She said she had 
no diarrhea, no cramps, no vomiting ; but that she had no appe- 
tite, and was sometimes hot and sometimes cold. We asked what 
the doctor called her disease. "Oh !" said she, "he called it dry 
cholera, and said it was just as bad as any kind." 

During the premonitory stage the pulse was more frequent than 
in health, with less force. The stroke of the heart was quicker, 
as well as more frequent than natural, and always showed decided 
evidence of debility. 

In the second stage we generally found the following character- 
istics : The surface mostly cool or cold, though occasionally warm 



256 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

and rather dry. When cool, moderate or free perspiration. The 
eyes were sunk deep in their sockets, and the whole face had a ven- 
ous color, which was sometimes slightly observable in the premoni- 
tory stage. The venous hue, of course, varied in intensity. The 
ears, hands, and feet had less warmth than the general surface ; the 
tongue was even cooler than these parts, and the breath below the 
natural temperature ; great thirst ; cramps of the extremities, but 
especially of the hands and feet. This, symptom was much more 
frequent in adults than in children, for in them cramps but seldom 
appeared. Diarrhea, which had been in the first stage wanting, 
moderate, or suspended for hours, now burst forth into copious 
purging of that peculiar fluid resembling rice-water. This fluid, 
with flocculent or fleecy matter floating in it, was universal in sub- 
jects under the age of puberty, and generally in persons under 
forty years of age. In those over forty, and older, the evacua- 
tions assumed the appearance of dirty water, or soap-suds which 
had been much used. This was much more ominous of a fatal ter- 
mination than the rice-water appearances. The periods between 
the evacuations were various. When these periods were short, 
we think there was less fluid discharged in a given time than when 
the evacuations were less frequent. 

It was appalling to witness the depressing eff'ects of large dis- 
charges from the bowels on the pulse. Sometimes it would become 
from comparative vigor, almost extinct, by a single action of the 
bowels. The discharges were sometimes involuntary, the least mo- 
tion causing a stream of watery fluid to flow ofi*; and even when 
the patient was perfectly quiet, they would occasionally pass away. 

During this stage the hands were often of a blanched and cor- 
rugated appearance ; but if vomiting took place at all, this symp- 
tom was not always present. When present, the food previously 
taken, frequently some hours before vomiting set in, was first 
thrown ofi* in an undigested state. After these emissions but little 
in general was vomited but drinks, and the peculiar liquid similar 
to or identical with the dejections. We frequently observed that 
vomiting, even more powerfully than purging, reduced the force 
of the heart and arteries, and, of course, had the efi'ect of hurry- 
ing t\\e patient more rapidly into the stage of collapse. We have 
repeatedly kept a finger on an artery during vomiting, and felt it 
growing weaker, until it became imperceptible before the vomiting 
liad ceased. 



ASIATIC OR MALIGNANT CHOLERA. 257 

Collapse. — The third stage, or that of coUapse, was characterized 
by hoarseness and a totally altered state of the voice, it becoming 
sometimes almost inaudible. The pulse persisted much longer, in 
bad cases, at the wrist, in the old than in the young. At the temples 
it generally became imperceptible as early as at the wrist ; indeed, 
in the old we think it sooner disappeared at the former than-the 
latter point. The great arteries of the neck could be felt, in gen- 
eral, until very near the last. We saw one case, however, where 
they could not be felt for six hours before death. It was com- 
mon, when this stage set in, for both purging and vomiting to 
cease ; occasionally, however, both these symptoms continued, 
vomiting more frequently than purging — this often from too much 
medication. Blindness was an occasional symptom, and the eyes 
were sometimes bloodshot. This last symptom is one of the most 
unfavorable that can occur. Patients during this, as well as the 
fourth stage, toss from side to side, sometimes for days. Another 
symptom was the total suppression of urine. This often occurred 
in the latter part of the second stage, and even throughout the 
whole course. When the patient occasionally passed urine during 
the second stage, there was a strong probability that reaction and 
ultimate recovery would eventually take place without the occur- 
rence of collapse. 

Fourth stage. — This stage is the one which terminates the worst 
cases of collapse when they do not terminate fatally, and begins 
so soon as the pulse in a collapsed patient can be felt at the wrist 
and temples ; also with the beginning of warmth of the surface. 
It is in this stage that the re-establishment of the circulation is 
brought about, that the liver is again thrown into its normal ac- 
tion, and that the kidneys perform their healthy functions. The 
skin now resumes its healthy action ; and now the patient may, in 
general, be considered convalescent; but often only one or two of 
these secretions occur, and then the patient has to succumb. 

Treatment — First stage. — When a patient said to us that he had 
no diarrhea, but otherwise had symptoms of cholera, such as cramps^ 
slight nausea, etc., we were much in the habit of giving one grain 
of opium and five of calomel, at bed-time, and directing that if 
the calomel did not purge by morning, a small dose of castor-oil 
or rhubarb should be given. After the bowels were evacuated, 
we directed a blue pill of five grains every night, or every other 
night, for a short time ; a fourth of a grain, or even half a grain 
17 



258 AMERICAN HOUSEHOLD BOOK. OF MEDICINE. 

of opium was given with each. So soon as the irritation of the 
stomach and bowels was quieted by this course, a table-spoonful 
of compound tincture of bark was directed, three times a day ; or, 
more frequently, one table-spoonful of brandy after each meal. 
The dose of these remedies was, of course, to be increased or less- 
ened, owing to the age of the patient, the circumstances of the 
case, etc. To these means were often added a warm or cold bath, 
once a day, either by shower or sponging. If convenience al- 
lowed, a plunge bath was directed. The patient was ordered to 
avoid all places of public resort, excepting church once a week, as 
well as undue excitement of every kind, and, above all, the expo- 
sure to the direct rays of the sun. All meetings held in basements 
■were to be especially avoided ; and the sleeping chamber to be 
freely ventilated, indeed, never closed, unless to keep out rain, or 
the heating rays of the sun ; and as few persons to occupy his bed- 
room as convenience would permit. 

Where diarrhea existed, or afterward supervened, the patient 
was directed to take about two grains of calomel, with half a grain 
of opium, every two or four hours, according to circumstances, 
until the bowels should feel comfortable. If opium was found to 
disagree, camphor, in equal portions with the calomel, was given. 

Small portions of morphine, in twelfth-grain doses, were given 
with the camphor and calomel ; and if there seemed little danger 
of exciting sickness of the stomach, the fourth of a grain of ipe- 
cacuanha was added. We occasionally directed pills, with a fourth 
of a grain of opium and the same amount of ipecacuanha, and one 
grain of calomel, which, in mild cases, were directed to be taken 
every hour or two. This amount of calomel might, with propriety, 
be reduced to half a grain, and the opium and ipecacuanha be in- 
creased to the same quantity. If the skin was found dry and 
warm during this stage, all the ipecacuanha that could be borne 
without the risk of vomiting, was given. 

In all the stages of premonition, the oil of turpentine was used 
every few hours as a liniment, on the abdomen, mostly, but often 
on the back and extremities. Occasionally baths of mustard and 
water, were ordered for the feet and hands. 

The food was crackers, and tea or coffee in small quantities ; 
and the fleshy parts of beef or mutton were allowed. Rice was a 
good deal insisted upon as a diet ; lemon-juice was admitted in the 
drinks in any quantity desired. When the patient was able to 



ASIATIC OR MALIGNANT CHOLERA. 259 

move about, summer fruits, such as strawberries, raspberries, and 
blackberries were admitted. 

There is a curious fact connected with recovery from the diar- 
rheal stage of cholera. It is this : that where diarrhea is checked 
during this stage, it is more difficult to get clear of the effects of 
the disease than where reaction did not occur until after the^sec- 
ond or third stage. Where this did take place in. the second or 
third stage, the patient would completely convalesce, in general, 
in a few days.* 

Second Stage. — In the treatment of the second stage, we gave 
five grains of calomel and half a grain of opium every ten min- 
utes, until our patient had taken twenty grains of the former and 
two of the latter. With each dose of the medicine was given one 
tea-spoonful of brandy, with small quantities of iced water, to 
wash it down. If the case seemed urgent, we gave fifteen drops 
of laudanum with each dose, for two or three times, in addition to 
the opium, and calomel. Often, in female cases, the opiate was 
given in little more than half the quantity, and two or three grains 
of calomel were given instead of five. We preferred to give the 
calomel in freshly-made pills, as being more likely to reach the 
stomach, and be retained there, than when given in powder. 

If, during this time, there were cramps of the muscles of the ex- 
tremities, or of the abdomen, mustard plasters were directed to those 
points, but in all cases the abdomen was occasionally oiled with tur- 
pentine. Not unfrequently flannels were moistened with the oil (or 
spirits) of turpentine, and applied to that region so long as they 
could be comfortably borne. Very gentle rubbing was directed, 
with soft flannel or the hand, but no severe friction was admitted. 
When the cramps were severe, they were mitigated by holding 
the limb firmly, so as to compress the muscles. The patient was 
directed not to raise his head, but to keep in a horizontal position 
all the time, as fainting might result in death. 

At the end of the first forty minutes, if there was no abate- . 
ment of the purging or vomiting, and if there was no urine, or but 
little, discharged, three grains of calomel, with the twentieth of 
a grain of opium, were directed, every ten minutes, until twenty 



*It will be observed by the reader that this article is written in the past 
tense, because we describe it as we saw it and treated it, in Cincinnati, during 
1849-50, and as we saw it in 1832. 



260 AMERICAN HOUSEHOLD BOOK OF. MEDICIXE. 

doses had been taken, or a mitigation of the symptoms had taken 
place. If, after the twenty doses had been taken, and reaction 
had not occurred, and the rice-water discharges continued, we 
persevered in the use of calomel and brandy — the former in two- 
grain doses every ten or fifteen minutes, the latter in tea-spoon- 
ful or even less doses, with iced water. This course was con- 
tinued until either collapse or reaction supervened. 

One of these generally occurred by the time that eighty grains 
of calomel and two or three grains of opium had been given. In 
some instances, but one grain of calomel was directed every ten or 
fifteen minutes, and that without opium ; for we seldom gave more, 
as has been said, than from two to four grains of opium in the 
treatment of any one case. In female cases, we generally pre- 
ferred sulphate of morphia to opium, as we thought it had a less 
deleterious efi"ect on the brain. 

To allay thirst, small pieces of ice were directed to be held in 
the mouth as often as the patient wished. Iced water or cold 
lemonade was given in small quantities, and vinegar and water 
were admitted as drink. The almost total abandonment of acid, 
fruits, and vegetables in those days, so far from warding off at- 
tacks of the disease, was, in our opinion, often injurious, and 
seemed of itself to indicate the use of vegetable acids. The re- 
peated chemical analyses of the excretions of cholera patients, by 
C. H. Raymond, failed to detect the presence of any acid, and 
seemed to point more strongly to that mode of treatment. 

So soon as the symptoms indicated the termination in reaction, 
the medicine was withdrawn. The rice-water purging being ar- 
rested, and a more healthy action of the heart and arteries estab- 
lished, the patient was allowed a rest of from six to twenty-four 
hours. The calomel already taken generally acted as a cathartic 
within the above limits, or, at the farthest, within two days. We 
found, to give purgatives was unnecessary in general, and unsafe, 
because, when purging was brought on by these, great debility 
occurred, and was, in some cases, the forerunner of death. Injec- 
tions of salt and water, given every few hours, were almost always 
sufficient to bring about an open state of the bowels. Brandy was 
continued until the pulse rose and the natural warmth had become 
generally diffused. In many cases, in females and in the temperate, 
no medicine was used beside calomel and opium, or morphine. 

An occasional symptom, common to both the second and third 



ASIATIC OR MALIGNANT CHOLERA. 261 

stages of the malady, is a claret color of both what is purged and 
vomited. We saw two cases of this kind. One was in an old 
man, in whose case the evacuations became of a cla,ret or slightly 
bloody color during collapse ; he died. The other case occurred 
in the practice of the late Doctor Foster Carroll. The patient, 
when first seen, was on the confines of collapse, purging and 
vomiting claret-colored fluid. The case was treated with calomel, 
and very small doses of opium. Of the latter, not more than one 
grain was administered, and of the former, one grain, with a little 
brandy and water, was given every five or ten minutes. This 
patient did not collapse, and recovered within a few days, reac- 
tion having taken place some twelve or fifteen hours after he was 
first seen by the doctor. 

Tiiird Stage. — We come now to the treatment of the stage of 
collapse, where death but too often triumphs over nature and the 
best-directed efi"orts of the physician. In no human malady do we 
feel so much trepidation as we do in the worst forms of Asiatic 
cholera, for in most other diseases we have time for dehberation, 
or can at least see, with tolerable certainty, the probable result. 
We meet an individual in the street, or on the road, in apparent 
health, and converse with him. In an hour or tvy^o w^e are sum- 
moned to his bedside, and find that in that time he has sickened, 
and is already sinking into collapse. His tongue and breath are 
cold, his limbs cold and shrunken, the skin discolored, and the 
whole surface bathed in clammy perspiration. The eyes are deeply 
sunken and dull, the vision is indistinct, and sometimes lost for 
minutes or hours, the pulse is no longer felt at the wrist or tem- 
ples, and there is no secretion of bile or urine; the voice is hol- 
low or lost, and always hoarse when it exists. The patient tosses 
from side to side, and passes rice-water discharges, perhaps in- 
voluntarily ; his limbs are racked with cramps, and he who but an 
hour or two since rejoiced in the buoyancy of active manhood, 
seems now only to claim relief from sufi"ering by death, which but 
too often follows. 

The whole aff"air has been so sudden that all but the medical 
adviser are thrown into confusion, and he, too, often partakes of 
the general alarm, and to that extent is disquahfied for rendering 
the needed medical assistance. He considers that all that can be 
done must be efi"ected within a very brief period, and directs per- 
haps more than can be useful, forgetting sometimes the powers of. 



262 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

the stomach. He does not reflect that this organ is not a steam- 
boiler, and that heat can not be restored by irritation where disease 
has so suddenly prostrated the powers of life. 
• The question now is how to arrest the rapid tendency to dis- 
solution. We have seen that much of the fluids of the system 
have been carried away in a serous and alkalescent condition, and 
the system has shrunk, within a short time, from its usual fullness 
to a state of great emaciation. The pulse is now only felt in the 
great arteries of the neck, yet the patient still breathes ; and vom- 
iting and purging have ceased, if not kept up by improper medi- 
cation. The whole circulation which now sustains life is confined 
to the brain, chest, and abdomen. 

What now will be the effect, if, after the patient has lost twelve 
or fifteen pounds of fluid, and the remainder is confined to the 
great centers of the body, you attempt to diffuse suddenly this 
quantity, already too small, throughout the general system? The 
answer is clear — death, in nearly every case. The heart is already 
feeble, contracting on a small amount of fluid only sufficient to keep 
up its pulsations ; and the brain, too, has barely an adequate quan- 
tity to prevent fatal congestion. Withdraw this, and death must 
be the inevitable consequence. We saw, in 1849, several cases 
resulting fatally from the use of external heat. One of these was 
a young man, or boy, about fifteen or sixteen years of age, who 
was brought into the First Ward Hospital, Cincinnati, and had col- 
lapsed twenty-four hours before we saw him. His physician and 
nurse thought he must die. He was placed on a straw bed and 
nursed carefully, but scarcely any medicine had been given him, 
and he was very lightly covered. He threw himself much about, 
and was often nearly naked. Another patient, two or three years 
younger, had been brought in before our visit. This patient was 
still only in the second stage. The house physician had ordered 
unslacked lime, in a moistened state, to be applied to his cold 
limbs. The warmth thus produced had reestablished the almost 
extinct circulation, and he was thought to be doing well. The 
stroke of the heart was very feeble. We heaved a sigh as we 
turned from him, believing that premature reaction had been 
brought about by external heat. We examined the other patient, 
advised a little brandy to be given occasionally, and felt that he 
would yet recover. On the following day this patient was better; 
the other was dead. The result, in both of these cases, in our 



ASIATIC OR MALIGNANT CHOLERA. 263 

opinion, amounts to almost positive demonstration of the truth of 
our position. 

When we were called to a patient who was either in a collapsed 
state or rapidly running into it, we pursued the following course : 
In the first place, we directed that all the windows in the chamber 
should be opened; that the attendants should be few; that-ihej 
should strictly follow directions, and should do as little to dis- 
courage the patient as possible; that friction should only be ap- 
plied when there were cramps, and, even then, that it should be 
moderate. It was directed that the body should be covered with 
flannel, or a light blanket or two, or only to an amount that was 
comfortable to himself; that the discharges from the bowels or 
stomach should be immediately removed ; that the abdomen should 
have turpentine applications constantly applied ; and that mus- 
tard poultices should be used, as in the second stage. Drinks 
should be given in small quantities, and should consist, as before, 
of iced water or lemonade, unless the patient should desire some 
other drink. Small pieces of ice were allowed to be held in the 
mouth. 

No heating substances were applied externally, for a period 
ranging from six to ten hours after the collapse had been ushered 
in. It was then directed that gentle heat, by means of hot water 
in bottles, or other warm substances, should be applied, for the 
purpose of gradually increasing the temperature of the sj^stem, or 
rather of the extremities. When the weather was cool, fire was 
kept in the chamber, at the same time that currents of fresh air 
were admitted from without. 

When we had not seen the patient before the beginning of col- 
lapse, we gave, as in the second stage, five grains of calomel and 
half a grain of opium, every ten minutes, until four doses had 
been taken. We then gave three grains of calomel and the twen- 
tieth of a grain of opium, at the same periods, until the vomiting 
or purging had ceased, or until sixty more grains of calomel had 
been taken. Each dose was washed down with a tea-spoonful of 
brandy and a little iced water. If the vomiting and purging con- 
tinued, we directed two grains of calomel and one-sixtieth of a 
grain of opium, until thirty doses had been taken. If now the 
purging continued, with light-colored evacuations and no flow of 
urine, half a grain of calomel was directed, every twenty minutes, 
until either death or reaction occurred. 



264 AMERICAN HOUSEHOLD Bt)OK OF MEDICINE. 

In the mean time, brandy and water were continued,, as before 
stated. The object was to give an ounce of brandy every hour. 
Where the patient had been in the habit of using spirits, the quan- 
tity was graduated to suit those habits. This course had often to 
be continued twenty-four, thirty-six, or forty-eight hours. ^ The 
quantity of brandy was often lessened after the first twenty-four 
hours, sometimes sooner ; and as soon as warmth was generally dif- 
fused, stimulants were withdrawn. Whisky may be used instead 
of brandy, if good. 

In the treatment of children at the breast, half a grain of calo- 
mel was directed every ten minutes, until death or reaction oc- 
curred. With each dose of calomel the hundredth part of a grain 
of opium was combined, and, in a few cases, more than this of the 
latter, though we now doubt the propriety of so doing. Ten drops 
of brandy, in iced w^ater, were directed with each dose of medicine. 
In older children, these doses were increased according to the age-. 

We now come to speak of the results of this plan of treatment. 
Only twenty-nine cases were collapsed, during 1849, in our hands. 
Many cases were arrested in their progress before the collapsed 
condition took place. Of the twenty-nine cases of collapse, nine- 
teen went through it successfully into the fourth stage, or that of 
reaction. Of these seven died, and twelve completely recovered. 
We now proceed to describe a few of these cases. It is, however, 
proper to say, that of the cases of collapse which were treated in 
1850 by us, a smaller number recovered than in the former year. 
There was more redness of the eye, and the collapse was more in- 
tense, the skin darker, and the breathing worse. We carried some, 
however, successfully through this stage in that year. It should be 
recollected that the summer of 1850 was considerably warmer than 
that of 1849; and to this cause we attributed the intensity of the 
collapsed cases. 

We shall, before concluding our relation of the course pursued 
in the treatment of this disease in 1849 and 1850, describe the 
treatment of a few cases, to show that no case can be so desper- 
ate that it ought to be abandoned, and to show that patients can 
and must be lost after our best efforts have been used : 

Mr. Church, aged fifty^ was very much exhausted from his at- 
tendance on a sick and dying family ; took diarrhea, which he 
totally neglected for some days, when he was hurried into the 
stage of collapse, which became profound a few minutes after we 



ASIATIC OR MALIGNANT CHOLERA. 265 

first saw Kim. The face was unusually blue, tongue very cold, 
hands and feet much shriveled, and very cold, voice nearly gone, 
heart irregular in its action, and breathing difficult. We took our 
usual course, but in a more determined manner. The calomel 
was given in large doses, and the brandy directed more freely; 
but the patient sunk steadily, and died in about ten hours. ''The 
evacuations in this case were unusually large ; he vomited consid- 
erably ; he suffered from cramps, and the skin acted more freely 
than was common. There were but feeble efforts at reaction, and 
medicine had no effect. 

Miss A., aged twenty-six, was taken June 15, 1849. She had 
had diarrhea for three days ; but much of this time had attended 
to her household duties. Some hours before we saw her, she fell 
into the second stage ; and when we first visited her, she was in 
a profound collapse. In this state she remained eighteen hours, 
having, during this time, neither pulse at the wrist or temples. 
The evacuations were as clear as thin starch, having a slightly 
flocculent appearance. She passed no urine during a period of 
seventy- two hours ; it did not flow for eighteen hours after reac- 
tion, and we presume she had really passed none for many hours 
before we saw her. At several times she lost the power of vision. 
This was especially the case four hours before reaction set in, when 
she was blind for some time, probably more than thirty minutes. 

In this case the course befor^ laid down was rigidly pursued, 
with this exception, that she took but one and a half grains of 
opium during the whole time. Two hundred grains of calomel 
were taken, and brandy was administered pretty freely ; for we 
suspected that she had been in the habit of taking a little when 
well. This patient recovered without being in the least salivated. 
The pulse rose, the heat became diffused, the dejections ceased, 
and the restlessness gradually wore away as the skin assumed its 
healthy functions. 

The following cases occurred at the Cincinnati Orphan Asy- 
lum, in 1849, of which we were then physician. There were but 
four well-marked cases of collapse in that institution during that 
year. 

We had given the most positive direction that if severe vomit- 
ing or purging should occur during our absence, half a grain of 
calomel and one-thirtieth of a grain of opium should be given 
every ten minutes, until we could see the patient. We had pow- 



266 AMERICAN HOUSEHOLD BOOK OF .MEDICINE. 

ders of that size for the purpose ; but our directions were not fol- 
lowed in the first two cases, and they both died — the first on the 
5th of August, an hour after our first visit ; the second lived only 
ten minutes after we saw it. 

The next case that occurred was treated in the manner above 
directed, the powders being washed down by twenty drops of 
brandy and a little water. The patient was three or four years 
old, and took twenty powders. This was dosing pretty largely in 
the w^ay of opium. The collapse continued eight hours, when it 
yielded to reaction ; and within a few days the fever, on the estab- 
lishment of a healthy action of the kidneys and skin, disappeared. 

Very soon after another case occurred, and the same plan of 
treatment was pursued as in the last case ; but, we believe, only 
twelve of the powders were given before reaction supervened ; but 
when purging came on, the evacuations, instead of a dark color, 
showed but little evidence of bile. At the end of a week, this pa- 
tient collapsed again. We directed the same powders, until twenty 
of them should be taken. Reaction now took place. The evacu- 
ations became dark, and .the patient completely recovered. 

Mr. Erickson, a delicate man, aged twenty-eight, was taken 
July 17, 1849. An empiric was called at 10 o'clock in the morn- 
ing, who gave him heating medicine, and adopted the following 
course : Half a table-spoonful of black pepper, and the same 
amount of common salt, with half a tea-spoonful of vinegar, to be 
taken hot as possible, and repeated every ten minutes until four 
doses should be taken. This brought on vomiting, which it could 
not, indeed, help doing. He, however, appeared better part of the 
day and night. The diarrhea still persisted, and in the afternoon 
of the second day he took ten more doses of the medicine at the 
same intervals. The consequence was a recurrence of the vomit- 
ing, which had the effect of relieving him of the poison nearly as 
soon as it was taken. 

At the close of this medication, he had become quite cold. 
Heating applications were now applied, but on the third day the 
patient had become collapsed. Various things were now given 
him. The tincture of prickly-ash bark was administered, in table- 
spoonful doses, for some time ; and frictions of cayenne pepper and 
brandy were used. Although the patient was now as cold as mar- 
ble, ice was constantly kept to his head, and continued through 
the ensuing night. During all this time, infusion of logwood was 



ASIATIC OR MALIGNANT CHOLERA. 267 

given as an injection, we know not at what intervals. Other things 
were added, and a tea-spoonful of laudanum at one time. 

The leading eclectic of the tribe was called, and justified what 
had been done, and said that the patient must die. One of the 
attending quacks said that he had given him enough to kill ten 
men. This was true, if the stomach had retained what had^been 
given him. 

We were called to this patient on the morning of the 20th, or 
at the end of three days from the time the empirics began their 
medication. He had then been in a profound collapse for six- 
teen hours ; the ice was yet on his head, and the pepper and 
brandy were being applied to his person. He was very restless, 
tossing himself from side to side, which produced great prostra- 
tion. The breathing was very laborious, and the heart much 
affected by the exertion. There was no vomiting, no purging, 
no pulse, and no discharges of urine. The breath and tongue 
were as cold to the touch as the surface of the body. There were 
occasional cramps, combined with the other symptoms. Under 
these circumstances, we began the treatment. One thing had been 
done by a friend of ours, during the preceding night, which was 
no doubt of much use in preserving life ; that was, the adminis- 
tration, every few minutes, of a little brandy and water, which 
was, fortunately, not rejected. We continued the brandy and 
water, in tea-spoonful doses, ev^ery ten minutes; that is, one tea- 
spoonful of brandy with about two of water were given. One 
grain of calomel, with the twentieth of a grain of opium, was 
directed, every thirty minutes. We could see but little advantage 
in giving, at this advanced stage, more of either of these reme- 
dies. The object in giving the opium was to obtain the stimulant 
effect, and it was expected that the calomel would excite the liver, 
kidneys, and skin to the healthy action, which is always neces- 
sary*to recovery. 

The frictions had been so constant and severe, with various ir- 
ritating applications, that much of the skin was partially abraded. 
This condition of the dermoid surface forbade all further exertion 
in that way. The extremities were simply covered with soft flan- 
nel, which was kept on with care. At 8 o'clock P. M., we could 
feel a little warmth about the neck, shoulders, and temples, and 
a feeble pulsation of the temporal arteries could be felt. On the 
morning of the 21st, the arteries could be felt at the wrist. The 



268 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

arterial action was more perceptible on the 22d, and on the 23d 
the reaction was general. On this day purging occurred both 
copious and dark; and in the evening urine was passed in small 
quantities. No purgative medicine was given, but one or two injec- 
tions of salt and water were directed. Brandy was given, in small 
quantities, throughout the collapse and reaction, but only at long 
intervals toward the last. There was salivation in this case for the 
first time with us. After the recovery, this patient enjoyed much 
better health than he had done for a long time. 

The next collapsed case which we treated was of a man fifty 
years of age. He was seventy-two hours without pulse ; still he 
recovered. But space will not allow the further relation of cases. 
We must, therefore, close this part of the subject. 

The foregoing has been drawn from what the writer experi- 
enced during the invasion of the cholera in 1832, and again from 
1849 to 1854 or '55. He believes he can not give a better de- 
scription of the disease than what he published in 1854. He has, 
therefore, drawn largely from what he then said. Many object 
to the use of mercurials in the treatment of cholera, but the writer 
thinks that, when properly combined with other remedial agents, 
it has done more in saving patients in this dreadful malady than 
all other medicines put together. 

The empiric has always been in the habit of abusing powerful 
medicines, because he knows he can best succeed by such a course. 
It is asked by physicians, sometimes. How can mercurials do good 
in a disease which requires such sudden medication ? It can only 
be replied, that if it does not at once benefit, it is ready to excite 
the action of the liver, kidneys, and skin into healthy action. It 
can, however, scarcely be doubted that the combinations of opium 
and calomel have a better efi'ect than either alone. The combina- 
tions also of blue pills with camphor, or other anodynes, are often 
of great use in diseases of a choleraic nature. 

The writer wishes to direct the attention of the reader to a plan 
of treatment which has been successful in India, and in England 
too. This method is recommended by Mr. C. A. Chavasse, of 
Smithwich, Birmingham. This surgeon had a very extensive ex- 
perience in the treatment of Asiatic cholera, both at home and 
abroad. He says : " I have seen every plan tried — counter-irrita- 
tion, brandy and laudanum, brandy and capsicum, cold afi'usion, 
transfusion; Stephens's saline with soda, and cliloride of sodium, 



ASIATIC OR MALIGNANT CHOLERA. 269 

and chloride of potash; the Australian sulphuric plan, mustard 
emetics, and calomel and opium and astringents, etc. — all with 
some degree of success, but all inferior to the plan I am about to 
recommend, and which I first saw put in practice in India, on a 
very large scale. I have seen many hundred cases treated with 
success by it. About one was lost in every eight. 

" The plan is as follows : 

'^Warm turpentine epithems (embrocations), or mustard poul- 
tices, applied to the abdomen frequently. Take calomel, prepared 
chalk, of each ten grains; make a powder, to be taken in molasses 
every hour, with half an ounce of the following mixture : Take of 
the compound powder of chalk, with opium, powdered gum arable, 
white sugar, of each two drachms ; sesquicarbonate of ammonia, one 
drachm and a half; cajeput oil, twenty minims; tincture catechu, 
three drachms; camphor mixture, eight ounces. Mix. 

'' The above to be given until the evacuations become feculent; and 
then the following substitute, until the purging be quite stopped. 
Take of acetate of lead (sugar of lead), half a drachm ; strong 
acetic acid, Bentley's sedative solution of opium, fourteen minims ; 
oil of cinnamon, four minims ; tincture of ginger, three drachms ; 
infusion quassia, eight ounces. Mix. An ounce to be given every 
two hours. Afterward, decoction of bark, with dilute sulphuric 
acid, may be given. 

" The strength must be supported by giving, alternately, strong 
beef tea, spiced with pepper-corns, and seasoned with salt and 
arrow-root, and with milk, w^ith brandy and nutmeg, between each 
dose of medicine. Cold water may be allowed, ad libitum. Flan- 
nel should be worn next the skin." 

There w411 be a necessity, in country places, for dispensing with 
some of these articles ; but the leading ones can be generally ob- 
tained. 

The powders can be kept ready for use ; so can the second pre- 
scription ; and, in the case of the appearance of cholera symp- 
toms, can be given by the friends of the patient until a physician 
can arrive. 

It is, however, the opinion of the writer, that an equally safe plan 
of treatment may be found in the following course, which is, that the 
following medication should be adopted. First, when the patient 
shows evidence of cholera, he should take one of the following 
pills: 



270 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

No. 100. Calomel 24 gr. 

Sulphate of morphia 3 gr. 

Pulverized gum acacia ^ dr. 

Mix. 

Make into twelve pills, or the same number of powders. One 
of the pills or powders may be taken every half hour, until the 
vomiting or purging stops, taking care not to give more than 
four doses .;within the first hour and a half, and then a dose may 
be given every four hours, if necessary. It is a good plan to di- 
rect one portion after each action of the bowels. The powders 
divided into two, or the pills made half the strength, would, in 
general, be strong enough in mild cases. Brandy may be given, 
in moderate quantities, between the doses of the medicine. 

In addition to this, we may say that we have seen much good 
derived from the following mixture : 

No. 101. Chloroform. . . , 1 dr. 

Laudanum 2 dr. 

Tincture of camphor i oz. 

Brandy 5 oz. 

Of this a table-spoonful may be taken frequently, with double 
the amount of water, until the vomiting and diarrhea, or both, 
shall be stopped. If this last prescription be relied on, two grains 
of calomel should be administered every few hours, until three or 
four doses are taken, or the evacuations fror^ the bowels become 
dark-colored, and then stopped. All medicine must be discon- 
tinued as soon as the patient is relieved. 

Prevention. — During the time that the cholera rages in any lo- 
cality, the inhabitants living in it should stay at home as much as 
convenience will allow, and live in the usual way. All extremes 
should be avoided. A table-spoonful of brandy might be taken, 
after each meal, with propriety. Flannel should be worn next the 
skin. All should use the plunge, shower, or sponge bath, once a 
day, when the health will permit. When cold water disagrees, 
warm salt and water may be used instead. The usual avocations 
should be, in general, pursued. Places of worship should only be 
attended once a week, and that only during the daytime ; and if a 
sense of religious duty does not forbid, should be dispensed with 
for a few weeks. Schools should be dismissed during th^ preva- 
lence of cholera in any neighborhood. 



DIABETES. 271 



Looseness op Bowels, or Diarrhea 



Frequent and copious discharges of foul matter by stool, accom- 
panied by griping, and sometimes by vomiting, characterize this 
disease ; but there is neither fever, nor inflammation, nor contagion. 

Emaciation follows long-standing cases. 

Treatment. — If the motions are frequent, and accompanied with 
bearing down, give an ounce of castor-oil, with fifteen to thirty 
drops of tincture of opium ;' but if the discharge from the bowels 
be abundant, give twenty grains of compound chalk powder, with 
opium, three times a day, allowing gruel, arrow-root, or sago, and 
forbidding all solid matter. 

But if the disease do not yield, the mercury, with chalk powder, 
one or two grains, should be added to each dose of the chalk pow- 
der ; or we may give Dover's powder, four or five grains, with the 
mercury and chalk. 

When the belly feels tender on pressure, calomel and opium, one 
grain of calomel and five of Dover's powder, thrice daily, with hot 
turpentine applications, or a blister to the belly. Various astrin- 
gents are given. 

No. 102. Aromatic confection 1 dr. 

I^ncture of catechu 1 oz. 

Chalk mixture 6 oz. 

Ginger syrup J oz. 

Tincture of opium 30 drops. 

Two or three table-spoonfuls after each liquid. 

Tincture of kino may be substituted for the tincture of catechu. 

Dr. Elliotson strongly recommends this : 

No. 103. Sulphate of copper -, |- gr. 

Powdered opium 1 gr. 

To be given thrice daily. 

To prevent attacks, avoid wet and cold feet, intemperance, and 
all improper articles of diet. 

Diabetes 

is divided into three species — one with limpid urine, not sweet ; a 
second with urine of the smell, taste, and color of honey ; in the 
third, the urine contains chyle. 

The symptoms of the first kind are white tongue, indigestion, 
dry skin, debility and depression, constipation, gnawing at the pit 



272 AMEEICAN HOUSEHOLD BOOK OF MEDICINE. 

of the stomach ; frequent desire to make water ; urine itself is 
greatly increased, amounting, in some cases, to forty pints daily, 
when the natural average is about forty ounces, or an imperial 
pint and a half. 

The specific gravity of the urine, in health, is from 10.15 to 
10.25 ; in diabetic urine it averages 10.40, and ranges from 10.25 
to 10.50. 

Causes. — Excessive use of liquids — of spirituous liquors ; a fit of 
hysterics causes undue secretion of the urine — any irritation, local 
or general. 

Treatment. — Abstain from drinking ; take animal food ; encour- 
age perspiration by a warm bath — by Dover's powder, five to 
eight grains, two or three times a day. 

Tonics or strengthening medicines, as muriatic or nitric acid, 
with opium, should be given. 

The honey urine diabetes is a very serious and mostly unman- 
ageable complaint. The patient's attention is first directed either 
to the quantity of water he voids, or to some shining spots on his 
boots, or on the ground, whenever a drop of his urine happens to ^ 
have fallen, on which spots the flies are observed to settle* The 
urine is of a pale straw color, smelling like hay — tasting sweet, and 
containmg sugar. There is constipation, white t(fngue, thirst, in- 
digestion ; gums red and tender ; throat dry, appetite inordinate ; 
the breath has sometimes an odor like that of hay. The patient 
becomes thinner, weaker, more irritable, and desponding; he be- 
comes melancholy and anxious. 

The disease may continue for months, or even years, until the 
patient dies exceedingly emaciated and exhausted. 

Carbuncles often accompany diabetes. 

Few people recover from an attack of this disease ; and the 
cure, if cure do take place, is always tedious and difficult. Dr. 
Eberle saw but one case of recovery out of six which were under 
his care. 

The causes are obscure ; there would seem to be an hereditary 
tendency. 

Treatment. — Three indications of treatment — first, to restore 
the defective power of the digestive apparatus; secondly, to cut 
ofi*, or restrict as much as possible, the supply of saccharine or 
sugary matter from without ; and, thirdly, to mitigate or remove 
distressing symptoms. 





/^?^ -^ 



DIABETES. 273 

As the very essence of the disease is placed in the digestive 
system, we should be able to cure the disease at once if we could 
procure a natural state of the digestion. 

We must, therefore, prevent any facility for adding to the sugar 
already in the system, by excluding every article of diet which is 
either saccharine in itself, or may be converted into saccharine 
matter. Animal food furnishes but scanty material for the forma- 
tion of sugar ;. accordingly. Dr. Rollo, some fifty years ago, dis- 
covered that a diet consisting exclusively of animal matter had a 
most extraordinary influence in reducing the quantity, and in less- 
ening the sweetness of the urine in this disorder. 

Could patients live long without eating any thing but exclusively 
animal food, it would be well; but none can long endure to do so; 
and then, with the slightest relaxation in diet, back would come the 
sugar in the urine, and suddenly the urine would be increased iu 
quantity. 

The animal diet may be varied; and all kinds of meat, game, 
poultry, and eggs, may be eaten freely, but without any vegetable 
matter. 

If vegetables must be permitted, green garden stuff, such as 
spinach, celery, cabbage, and the like, may be taken with less risk 
of increasing the sugar in the urine than potatoes and those vege- 
tables which contain a proportion of sugar or of starch. 

When the patient will not be ruled as to diet, and indulges with- 
out restraint, the disease advances with rapidity, and is soon fatal ; 
but, with care, life may continue for several years. Neither are 
medicines useless ; for they may prevent more mischief than would 
otherwise exist, and they may decidedly control the diseased ac- 
tion going on. 

The drain upon the powers of the body, caused by the common 
discharge, is the origin of the emaciation and hectic ; and if some 
portion of the food were not taken up and employed in the pro- 
cess of nutrition, a fatal event would soon take place, and our 
object should be to increase the quantity of food, which is sup- 
porting the strength. A judicious system of diet is to be recom- 
mended, one that will least increase the saccharine matter in the 
blood and urine. Fruits are bad. Bread, if it must be eaten, 
should be stale and well fermented, and there is a bread made 
for diabetics, called gluten bread. The meals must be moderate ; 
great eating would be dangerous. Drinks to be limited, and con- 
18 



274 AMEHICAN HOUSEHOLD BOOK OF MEDICINE. 

sist of tepid animal brotlis or distilled water. If the patient have 
been used to much drink, diminish it gradually. 

Cupping or leeching is sometimes useful. 

Opium is a powerful drug here. It quiets irritation and checks 
the discharge, although it will not prevent the formation of the 
sugar. Dover's powder contains opium; give five grains of it 
thrice daily. If the ipecacuanha in this Dover's powder disagree, 
by causing or increasing vomiting, then give opium alone, half a 
grain in pill. Then hot-air bath, warm clothing, flannel, skin rub- 
bing, are beneficial. 

Creosote, one drop, with gum arable; mucilage, one drachm ; and 
water, one ounce, three times a day ; or it may be given in pills, 
Professor Berndt cured a case by eight drops, daily, of creosote. 

Mercurials are to be avoided. 

Aperients may be used when necessary. 

Dr. Clay tells us of three cases cured by the following mixture, 
and no relapse followed : 

No. 104. Tincture of muriated iron 2 drs. 

Sulphate of quinine 8 grs. 

Tincture of opium 90 drops. 



Distilled water 6 



oz. 



Of this, two table-spoonfuls, every four hours, were given. 

The permanganate of potash, two or three grains thrice daily, 
has cured. 

But there is a long list of remedies which have been narrated 
as infallible, yet have never stood the test of a fair trial. 

Sugar in urine occurs in that of man alone, and of no other 
animal. 

Dr. Percy recommends the following as a substitute for bread. 
Take the woody matter of sixteen pounds of potatoes, washed free 
from starch; three-quarters of a pound of mutton suet; half a 
pound of fresh butter; twelve eggs; half an ounce of carbonate 
of soda, and two ounces of dilute muriatic (hydrochloric) acid. 

Divide this quantity into eight cakes, and bake in a quick oven 
till nicely browned. 

Milky or Chylous Urine is a rare disease. The urine is of 
a milky appearance, and coagulates into a jelly-like substance,' 
which separates into a white clot and a clear yellowish fluid; or 
a white flaky matter is deposited ; or a white cream arises to the 
surface. 



CONSUMPTION. 275 

This disorder may be partially relieved by blood-letting, spare 
living, sweating medicines, laxatives, and opiates ; there is no cure. 



Atrophy, or Mesenteric Diseases. (See Diseases op 
■ Children.) 

Consumption. 

This fatal disease begins in various ways, and often fails to at- 
tract attention till the malady is far advanced. 

Sometimes it appears after a common cold or catarrh, when the 
cough continues troublesome, long after the other symptoms have 
disappeared; or it may follow other diseases; or it may set in 
with merely a short dry cough, occurring on rising in the morn- 
ing, and so slight that attention is not attracted to it. 

The earlier symptoms will be weakness and languor, with a 
disinclination for any exertion ; there is more or less of difficulty 
of breathing, or rather shortness of breath ; want of appetite ; 
some thirst, and a pulse either habitually too quick, or else too 
easily accelerated. 

Then the patient expectorates or " raises " a little, and a little 
blood appears in the expectorated matter. 

After a time these symptoms become more and more trouble- 
some, and perhaps a considerable quantity of blood is thrown up 
by coughing ; thfti the mucus thrown up begins to change its char- 
acter, becoming thicker, and mixed up with little round masses of 
a peculiar matter, wrapped up in the mucus, or free from it; 
these masses, on agitation with a stick in water, will sink to the 
bottom ; there is often a hoarse voice as a very early symptom ; 
and now hectic fever sets in. 



Hectic Fever 

is a remittent fever, arising from local irritation in weakened 
habits of body. 

Its symptoms are chills, then flushings of face, a hot skin and 
frequent pulse, to which perspiration succeeds, forming a par- 
oxysm of hectic fever. 

Two such paroxysms occur every twenty-four hours — the first 
usually about noon, which abates in four or five hours ; but it is 



276 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

soon succeeded by the more violent paroxysm^ which does not 
terminate until 2 o'clock in the morning, when sweating puts an 
end to it. 

The usual febrile symptoms mark this fever ; the pulse ranges 
from 98 or 100 to 130, but always remains too quick ; the urine 
is high colored, with sediment ; but the cheeks are flushed, and 
there is a florid, circumscribed redness; there is also a sense of 
burning heat in the palms of the hands and soles of the feet. 

The patient rapidly loses flesh; the appetite falls off; sweats, 
which seem to melt away the strength, are checked only to be 
followed by exhausting diarrhea ; when at length the respiration 
becomes very difiicult, and death releases from sufl'ering. 

The treatment of hectic varies with that of the disease of which 
it is an accompaniment. 

The expectoration is at first of mucus ; then little points of mat- 
ter, like softened cheese, are seen, which sink in water ; sometimes 
the expectoration is more or less yellow or green ; but the expecto- 
rated matter most characteristic of consumption are globular fleecy 
masses, which, when spat into water, spread out in a round form, 
like a piece of money; hence the French call these masses num- 
mular expectoration. Louis says he has met with these round, 
separated, woolly masses only twice, unconnected with tubercles ; 
still they are not characteristic of consumption, but may sometimes 
be met with in other diseases. 

The changes which take places in the lungs #e ascertained by 
listening to the sounds made in breathing, to do which effectually 
a practical study of auscultation must have been gone through ; so 
we omit these indications, saying merely that they point out to 
the practiced ear the site of the diseased deposit in the lungs, the 
extent of the deposit, and the changes in it, the softening of the 
matter. 

The approach of consumption is often very insidious — debility, 
emaciation, indigestion, etc., etc., with slight cough — -but, in all 
cases, there is a marked undue quickness of the pulse, while it is 
also small. Dr. Guy, in some excellent practical remarks, says 
that he has Been the pulse amount to 140, when debility was the 
only marked symptom. Pain in the forehead and eyes, and also 
palpitation sometimes, are the first symptoms which attract atten- 
tion. 

We will now speak of spitting or coughing of blood. 



HEMOPTYSIS, OR SPITTING BLOOD. ' 2T7 

HAEMOPTYSIS, OR SpITTING BlOOD. 

This discharge of blood is frequently caused by the existence 
of tubercular matter in the lungs ; and in 1,381 cases of consump- 
tion, it occurred in the proportion of 63 per cent. 

Symptoms. — Oppression at the chest, dry tickling cough, pulse 
frequent, difficult breathing, salt taste in mouth, flushed face ; then 
a cough, with discharge of more or less blood; more or less of fever. 

Causes. — A certain age, from about fifteen to forty-five; a full 
habit; hereditary predisposition; and it may be excited by exer- 
tions in singing, etc.; by the suppression of certain discharges, as 
of the menses, for one ; by certain states or disorders of the heart ; 
by tuberculous deposit. "We must distinguish blood brought up 
from the lungs by its florid red color and frothy admixture, by its 
expulsion through the means of a cough. 

We should examine the nostrils, gums, and upper gullet, to 
make sure that the blood does not come from thence. 

Now this haemoptysis may be cured in almost all cases, except 
those in which consumption has become declared and confirmed. 

Treatment of Coughing of Blood. — We must remove fullness in 
the chest by a blood-letting, if the pulse be full and the face flushed, 
or if there is much distress of breathing, and if the blood is thrown 
up in considerable quantity. But we may leech or cup in less 
grave cases. 

"We must keep the patient quiet by low diet, repose ; cold liquids 
or ice ; and the patient's head should not be suff'ered to lie low. 
Then, when the system has been freed from fullness of vessels,, 
and from active fever symptoms, we may give astringents. 

No. 105. Dilute sulphuric acid 15 drops. 

Tincture of opium 10 drs., or more. 

Syrup of roses 1 dr. 

Water 1 oz. 

To be given every third or fourth hour. 

If these acid draughts do not stop the bleeding, give the sugar 
of lead (No. 105) ; but watch the gums for the blue line, as described 
at lead colic. Stop as soon as this blue color begins to appear. 

No. 106. Purified sugar of lead (acetate of lead) 6 to 12 gr. 
Extract of opium 3 gr. 

Add conserve of roses, enough to make into six pills ; one to be 
taken three or four times a day. 



278 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Or it may be taken in a fluid form, as follows : 

No. 107. Purified sugar of lead 2 or 3 gr. 

Dilute acetic acid 30 drops. 

Tincture of opium 5 to 10 drops. 

Syrup 1 dr. 

Water 1 oz. 

To be given every four hours. 

While this acetate, or sugar of lead, is given, vegetables must 
be avoided, as also every thing which might bring on an evolution 
of carbonic acid gas ; for then a carbonate of lead would be formed, 
and the carbonate of lead is poisonous. 

If hemorrhages have been thus checked or stopped, we may give 
alum. 

No. 108. Alum (sulph. of alumine) 10 gr. 

Epsom-salts -J to 1 dr. 

Diluted sulphuric acid 20 drops. 

Syrup of white poppies, or simple 

syrup 1 dr. 

Distilled water. 1 oz. 

Every four hours. 

Treatment of Consumption must be varied according to the state 
in which the deposit in the lung may be. 

Before the deposit has softened, repeated counter-irritation 
should be tried ; sea voyages in tropical regions during the cold 
seasons ; uniform temperature ; a residence in certain climates. 
(See Climatology of United States.) 

With these, if there is no excitement, give cod-liver oil, prepa- 
rations of iron, in small doses; liniments to produce an eruption. 
(See ScROEULA.) 

In the stage of softening, where there is abundant expectora- 
tion, an emetic or two every week, for two or three weeks. 

No. 109. Tartar emetic J to 1 gr. 

Powdered ipecacuanha 20 gr. 

Or this : 

No. 110. Sulphate of zinc 20 gr. 

To be taken in the morning, and warm water or camomile tea, to 
encourage the vomiting. 

Then we must obviate the most distressing symptoms — the night 
sweats — ^by the sulphuric acid draughts, 20 drops for each dose. 
Sponging the chest every night with warm nitro -muriatic lotion 



CORPULENCE. 279 

has been useful in my practice, and husbanded the strength. For 
the distressing cough, emulsions. 

No. 111. Almond emulsion 6 oz. 

Tincture of opium 1 dr. or more. 

Medicinal hydrocyanic acid 6 to 10 drops. 

Ipecacuanha wine, or tincture of , 

squills, of either , 60 to 90 drops. 

One-sixth part, two or three times a day. 

Against the wasting diarrhea, give the chalk and opium, or chalk 
and catechu mixture. (See Diarrhea.) 
A night pill : 

No. 112. Compound squill pill 2 gr. 

Soap pill 4 gr. 

Blue pill 1 or 2 gr. 

Make two pills, to be taken every night at bed-time. 

Inhalations relieve some ; an(f warm water, with a few drops of 
henbane in it, may be inhaled. 

For side-pains, use mustard poultices, blisters, stimulating lini- 
ments. 

Corpulency 

may become an absolute disease. If the secretion of the bile is 
impeded, the fat is slowly absorbed from the body. The fat may 
be reduced, if the patient will follow directions. 

Dr. T. K. Chambers found that by gradually reducing the diet 
down to a small quantity, and giving 30-drop doses of the liquor of 
potash, much benefit has been derived. He raises the dose from 
30 to even 90 drops, three times a day, in milk and water, as the 
best vehicle. Soap is an old remedy for too great corpulence. 

Ten ounces a day of solid food are sufficient. 

Breakfast should consist of dry toast or sea-biscuit ; and if much 
active exercise is taken, a small piece of lean meat. Dinner early — 
about one o'clock — on lean meat, stale bread or biscuit, maccaroni, 
or biscuit pudding. No liquids at the meal, but in half an hour 
afterward. No more solid food during the day. For supper, a 
piece of biscuit, with some water ; a cup of gruel before going to 
bed. 

We must not despair of so reducing the weight as to enable the 
person to take exercise ; and the later in life the disease com- 
mences, the more favorable the result. 



280 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Fat, oil, butter, and all oleaginous food should be interdicted. 

For exercise, walking, riding, rowing, or shooting. 

Vinegar is used by many in great quantities, and it was a great 
favorite with young ladies who wished to be genteelly thin ; but it 
can only be successful by producing indigestion, or by destroying 
the powers of the stomach, and preventing it from digesting any 
thing. 

Dr. Chambers gives several instances of great obesity being re- 
duced by giving the liquor of potash, as ordered above, and by a 
steady adherence to the diet recommended. 

Arsenic influences the secretion of fat ; but it is a remedy only 
fit for medical men to use ; and it acts, perhaps, prejudicially on 
the stomach, so as to impede due digestion of the food taken. 

Windy Swellingts — Emphysema. 

This sort of swelling arises from a distension or blowing up of 
the cells in the cellular membrane of the body. It is imitated by 
butchers when they blow up veal for sale. It is generally caused 
by a broken rib, or a wound in the chest; for in these cases, as 
the air is drawn into the lungs during respiration, so it issues 
forth by means of the communication made between the inside and 
outside. Every successive inspiration adds to the size of the 
swelling, until the whole body is swollen to an alarming size, the 
features being greatly swollen, as well as the rest of the body. 
On pressure with the finger, a crackhng may be heard, which is 
caused by the air being pressed from one cell into another. 

This emphysema need not give alarm when it is a consequence 
of a broken rib, since it will disperse as the rib bone unites. It 
sometimes arises spontaneously, or occurs after delivery. 

Treatment. — Evacuate the air by scarifications ; that is, dipping 
the shoulder of the lancet or knife into the swelling, just deep 
enough to penetrate to the confined air ; then press with the hand. 

If difficulty of breathing and pain exist, bleeding and laxatives 
may be useful. 

Rub the distended skin with spermaceti ointment. 

But there is another kind of emphysema, which exists in or on 
the lungs, and within the chest, brought on by straining efi"orts of 
the voice, violent cough, by certain diseases, and by certain states 
of the heairt. 



TYMPANY. 281 

The general signs of this state are : Habitual dyspnoea (difficulty 
of breathing) ; fits of hard breathing ; cough sometimes ; palpita- 
tion as the disease advances ; no fever. The fits occur in the 
night, and on lying down ; or they are severe, if there be much 
wind in the stomach ; dropsy of the ankles, which creeps upward. 
The expectoration is of a thin fluid, like gum-water, and fuH of 
foam. 

At length the countenance becomes pale and of bluish color; 
the body is emaciated ; and if inflammation be added, death soon 
ensues. These are signs, very distinctive ; but he alone who can 
use the stethoscope can make himself acquainted with them. 

Treatment, — No cure. We must remove aggravating causes. 

Warm weather agrees ; hence w^arm clothes in cold weather ; the 
feet to be kept dry and warm. 

To harden against colds and inflammations being brought on, 
apply tepid shower bath, until the cold shower bath can be used. 

If the fits are violent, or the difficulty of breathing great, and 
the wheezing is heard loud and long, we may cup between the 
shoulders, and give the following : 

No. 113. Compound spirits sulphuric ether.. 30 drops. 

Acetate of morphia ^ gr. 

Camphor mixture 1 oz. 

The blueness of the lips, which deters us from giving opium 
in bronchitis, here depends more on the temporary or spasmodic 
state, and opium acts beneficially. 

The emphysema, just described, is called the vesicular, consist- 
ing of an enlargement or rupture of the air-cells; and there is 
another kind, called interlobular, in which the air is contained, not 
in the enlarged air-cells themselves, but in the cellular membrane 
of certain parts of the lungs. 

This will cure itself, and little can be done by art to accelerate 
the absorption of air. If air appear under the skin, or there is a 
crackling on pressure, let out the air, and press. 

Tympany 

is 'a violent drum-like distension by gas of the bowels or the belly 
itself. 

The disease may come on suddenly or slowly; flatulency and 
aoises in the bowels are heard, and the air is frequently expelled 



282 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

both upward and downward; there are colicky pains; the belly 
is swollen, hard, and tense as a drum; it sounds hollow; costive- 
ness and difficulty in making water all attend on this disease. 

When the air escapes from the bowels, through some ulceration, 
it is the second kind of tympany. 

Causes. — Any thing causing loss of tone in the bowels; errors 
in diet ; abuse of purgatives, of spirituous liquors ; crude or badly 
boiled vegetables ; nervous irritability or sensibility. 

Treatment — We must procure the ejection of the air, and pre- 
vent its reaccumulation. Give ether, oil of aniseed, oil x)f turpentine, 
ginger, cardamoms, capsicum, horse-radish root, tincture of rhu- 
barb, alum. (See the remedies for Flatulence, under the head of 
Indigestion.) The assafetida clyster is very efficacious usually, 
or turpentine thrown up. 

The belly may be rubbed with warm stimulating liniments, or a 
tight bandage may be applied. 

To prevent the recurrence, give tonic (bitter) infusions. (See 
Indigestion.) All food of flatulent nature must be avoided, reg- 
ular exercise taken, and warm, cordial aperients every now and 
then administered, such as this : 

No. 114. Tincture of senna 1 oz. 

Wine of aloes 2 oz. 

Peppermint water 3 oz. 

Syrup of ginger J oz. 

Three table-spoonfuls occasionally, when costive. 

When the air has collected, or is situate in the cavity of the 
belly, having escaped from the bowels, some recommend tapping 
the belly with a small pipe, etc., called a trocar. 



Dropsy 

is mostly a sequel, sign, or symptom of another disease, but the 
imprisoned fluid is often a cause of various symptoms which carry 
with them imminent danger to life. 

Dropsies have been divided into active and passive — into dropsy 
in the head, heart, or chest, kidneys, belly, and cellular mem- 
brane. 

Dropsy first showing itself in the ankles is usually a dropsy 
originating in some heart afi*ection. When, in addition to the 
swelling in the ankles, a puffiness is observed in the face and 



DROPSY OF THE CELLULAR MEMBRANE. 283 

eyelids, it is probably dropsy from disease of the kidney. When 
the water first shows itself in the belly, it is a liver dropsy. 

Dropsy of the Cellular Membrane, or Anasarca. 

This kind shows itself at first with a swelling of the feet" and 
ankles toward evening, Avhich disappears in the morning, after a 
night's recumbent position. 

The swelling is usually soft and inelastic, retaining for some time 
the pit from the pressure of the finger. By degrees the swelling 
ascends, and occupies the thighs and trunk of the body, and con- 
tinues to increase till the face and eyelids seem to be bloated. 
There is a hard, tense, brawny kind of swelling; here the fluid 
would not seem to have broken down the cells. When an in- 
crease of the fluid at length breaks them down, then the swelling 
becomes soft, doughy, pitting on pressure, with a shining glazed 
skin. After a time, difficulty of breathing, with cough and expecto- 
ration of a thin, watery fluid, are added. The urine is high-colored 
and scanty in quantity; costiveness, thirst, yellow skin, emacia- 
tion; lastly, heaviness, stupor, and slow fever. 

The anasarca from cold comes on suddenly, and is of the hard 
kind of swelling; in that from rheumatism and disease of the heart, 
there are palpitation and difficulty of breathing, increased on ex- 
ertion, as walking up ascents ; short, dry cough ; the patient can 
draw in a full breath easily; eyelids and cheeks swollen in the 
morning; pulse quick and weak, or full and soft; the urine does 
not coagulate by acid or by' heat; nights restless. 

Anasarca from disease of the heart is characterized by symp- 
toms of diseased heart. 

The dropsy from kidney disease : Besides the usual symptoms, 
the skin is singularly dry and pale; the urine will coagulate by 
acids or heat, and may be copious or scanty ; its specific gravity 
diminishes, and there is often a deficiency of urea in it. There 
may have been pain in the region of the kidney, felt for some 
time before the dropsy came on, or some irritation in the bladder 
is seen in some cases. 

The brain soon becomes oppressed in these cases of renal 
dropsy, and drowsiness, stupor, and coma are not unusual. 

Anasarca may arise from a stoppage of the menses, or after 
ecarlct fever. 



284 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

The dropsy that supervenes upon scarlet fever generally begins 
from the fourteenth to the eighteenth day after the scarlet fever 
has commenced, and it is sometimes formidable. 

Causes of Anasarca. — All causes of debility form the tendency. 
Exciting causes are certain diseases producing an obstruction to 
the free circulation of the blood ; such as those of the heart, of the 
lungs, and of the kidneys ; suppression of accustomed discharges 
or eruptions, or the sudden disappearance of the latter ; intemper- 
ance in drink ; pressure on the veins in several parts. 

We may take a favorable view of the result, if the cause of the 
disease admit of easy removal, if the strength is not impaired, if 
the appetite be good. 

Treatment of Anasarca, — We must try to remove the causes, 
to evacuate the fluid, and to strengthen the habit. 

To evacuate the fluid, active purgatives, diuretics, or diaphor- 
etics (sweat-producing) remedies are employed. 

Active purgatives answer very well for the first, second, or third 
times, but, by repetition, they lose their power ; then larger doses 
are given; yet the stools are still incomplete and painful. A more 
powerful dose is given, and then pain is felt, and an inflammatory 
state of the bowels is brought on. 

Our best plan is to alternate purgatives with diuretics or dia- 
phoretics ; never to combine them in the same prescription. Elate- 
rium, gamboge, jalap, colocynth, croton oil, supertartrate of potash 
may be given. 

No. 115. Elaterium extract 2 grs. 

Sugar 1 dr. 

Rub well, mix, and divide into eight powders. Give one every 
fifteen or twenty minutes, till free watery motions are produced. 
But this elaterium excites so distressing a sickness, that few can 
long persevere. Cream of tartar is much praised, and Dr. Eberle 
especially recommends the following combination : 

No. 116. Cream of tartar 1|^ oz. 

Sulphate of potash -J oz. 

Powder of dried squills 2 drg. 

Tartar emetic 2 grs. 

Mix. 

A tea-spoonful of this may be given four or five times daily, 
daily, with benefit. 

Or this imperial drink : 



DROPSY OF THE BELLY. 285 

No. 117. Cream of tartar |^ oz. to 1 oz. 

Sugar J lb. 

Recent lemon-peel 3 drs. 

Boiling water 3 pints. 

Mix. 

Diuretics are perhaps the most efficacious, where there is no 
disease of the kidney. 

No. 118. Blue pill 2 grs. 

Compound squill pill 3 grs. 

Make a pill, to be taken every night, but watch the gums ; and 
do not salivate. The squill will disagree with many, even in very 
small quantity. 

No. 119. Acetate of potash J oz. 

Spirits of sweet niter -J oz. 

Decoction of fresh broom 8 oz. 

Two table-spoonfuls thrice daily. 

The foxglove is often given, but it should only be given by a 
medical man. 

Where remedies can not be borne, when taken into the stom- 
ach, we may try rubbing in the following : 

No. 120. Tincture of squills,"] 

Foxglove, >- of each i" oz. 

Colchicum seeds, j 

Camphorated oil 1-|- oz. 

This is to be rubbed in for from ten to twenty minutes, by means 
of flannel. 

Scarifications, or what is called acupuncture ; that is, introduc- 
ing a needle's point, by a rotary motion, into the skin, at various 
points. A small bead of fluid will appear, and a good deal of 
the fluid will drain away, in this manner, with time. 

If the fluid is discharged, give tonics, good food, good air, and 
exercise, so as to strengthen the patient as much as possible. 



Dropsy op the Belly. 

Here the belly swells progressively; the fluid can be felt by 
the finger. 

The general symptoms which arise are those caused by the pres- 
sure of the fluid ; difficulty of breathing ; full and sufi'used face 
and eyes ; thirst ; a dry skin ; scanty urine, and torpid bowels. 



286 AMERICAN HOUSEHOLD BOOK 01? MEDICINE. 

Causes. — Disease of the liver, spleen, or any tumor pressing on 
the veins. 

Treatment. — If there be pain on pressing the belly, leeches 
should be applied, and then mercury, so as to affect the gums 
slightly. 

The list of remedies are the same as for anasarca — purgatives, 
diuretics, etc. ; but when all have been tried, and the distension 
is very great, tapping must be advised. 



Dropsy of the Chest 

comes on gradually. At length there is felt a sense of oppression 
or weight at the lower part of the chest-bone, with slight diffi- 
culty of breathing when at rest, and in an erect posture. The 
sufferer tries to lie down, but finds he can not, from a feeling of 
suffocation which ensues ; his pillow must raise the head very high, 
or a feeling of suffocation will follow. All bodily exertions ag- 
gravate ; the sleep is dreamy, and the patient awakes in terror ; 
the pulse is irregular, perhaps intermits, and is hard to the finger; 
thirst is urgent, and the urine scanty and high-colored. 

As the disease advances, the lips become of a dark or purple- 
red, the face pale or livid, and the difficulty of breathing increases; 
the legs and hands cold. If the fluid is only on one side of the 
chest, he can lie down only on that side. 

Treatment. — A favorable result must depend on the accompany- 
ing disease. We must first reduce any inflammatory tendency, if 
any exist, by cupping, leeches, tartar emetic embrocation to pro- 
duce an eruption. 

To get rid of the fluid, the purgatives, as elaterium, scammony, 
etc. ; the diuretics of acetate of potash, sweet spirits of niter, in- 
fusion of digitalis. 

Diuretic Mixture. 

No. 121. Acetate of potash 30 grs. 

Sweet spirits of niter 1 dr. 

Infusion of foxglove \ oz. 

Peppermint-water 1 oz. 

Three times a day. But the foxglove must be watched ; and if 
the pulse suddenly lowers, or a feeling of lowness or faintness 
comes on, the foxglove must be discontinued. 
. I have been obliged to give blue pill, or calomel — three grains 



THE KIDNEY, OR RENAL DROPSY. 287 

of the former, and one of the calomel — night and morning, to very 
slightly touch the gums. As soon as this happens, the urine is 
increased by the diuretic mixture directly. 



The Kidney, or Renal Dropsy. 

To the general symptoms of dropsy already detailed, there are 
some symptoms added, showing the complication of the kidney as 
a cause ; pain in back ; instead of the dark red lips and bluish 
countenance, we see a dingy sallowness of skin, and the urine is 
coagulable by heat, and it is of lower specific gravity than is na- 
tural. The lower, the greater danger ; and a density of 1018 to 
1010 betokens great danger. The specific gravity is ascertained 
by a peculiar instrument called a hydrometer. 

Treatment. — If there is pain in back, cup ; but do not take away 
much blood. Here diuretics must not be given. Purgatives and 
sweating medicines are to be given. 

Dr. Osborne says, when a patient was under his care with gen- 
eral swelling, (oedema,) coagulable urine and dry skin, I directed 
him to keep his bed. A purgative was first given — the senna mix- 
ture in preference to others — then foot baths, hip baths, or gen- 
eral baths were ordered ; the last either of water or of vapor. At 
night, eight grains of James's powder, with four of Dover's pow- 
der, were given. 

The usual drink was barley-water ; but if there were any stupor 
or headache, the Dover's powder was omitted. 

While in the bath, two drachms of ammoniated tincture of guai- 
acum were given. 

If the baths were followed by cold feet and legs, they were dis- 
continued. Then give : 

No. 122. Carbonate of ammonia 30 grs. 

Camphor mixture 6 oz. 

One ounce to be taken every two or three hours. Warm bags dur- 
ing the day. 

As soon as perspiration sets in, amendment or recovery may be 
hoped for. During convalescence, bandages and exercise ; nutri- 
tious diet. 

Water in the head. (See Diseases of Children.) 

Scrofula. (See the same.) 



288 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Skin Diseases. 

The Chicken Pox — Varicella. 

Slight fever for twenty-four hours, then reddish pimples, which 
on second day contain a colorless fluid — vesicles they are called. 
On the third day the colorless fluid becomes yellowish ; soon after 
they break, or are accidentally broken, and a thin scab is formed. 

Generally before the fifth day the whole eruption disappears. 

Treatment — Seldom necessary. Gentle aDerients, with saline 
draughts, if there is fever. 

False Measles — Rose Rash — Roseola. 

Slight febrile symptoms, then patches of difi'erent form and size, 
of a deep rose color, which disappear in from two to seven days. 

Causes. — Teething, irritation of stomach or bowels. It is some- 
times epidemic. 

Treatment. — Salines ; aperients ; a warm bath or two. 

Atonic Ulcer, or Rupia. 

This disorder is observed in persons of unhealthy habit, who are 
what are called cachectic ; that is, in a bad state of health from 
previous disease, or exposure to unwholesome influences. 

The eruption consists of round, flat vesicles, about as large as a 
dime, which are filled with a serous fluid. 

This fluid changes into pus, or yellow matter. The vesicles 
shrink, and thick brown crusts form, beneath which crusts the skin 
ulcerates. The scabs fall off ; the ulcers heal more or less quickly. 
The eruption affects chiefly the legs. 

The duration of the disease is from a few wrecks to several 
months. 

Causes. — Every thing which produces an unhealthy habit of 
body. One species sometimes terminates fatally ; it occurs in in- 
fants. 

Treatment. — Our attention must be directed to the general state 
of the body, and we must try to produce healthy blood by regu- 
lating the secretions, giving tonics, as bark, steel, wine, etc., and 
stimulants. Locally, by warm baths, or by alkaline baths. To 
the ulcers, lunar caustic, stimulating ointments, etc. 



TETTER, OR HERPES. 289 

Tetter, or Herpes. 

This is a non-contagious affection of the skin, with an eruption 
of globular vesicles, situated upon inflamed patches of skin, of an 
irregular form, and of small extent. 

There are usually no signs of constitutional disturbance, an(t the 
disease lasts for two or three weeks. 

Each vesicle continues for about ten days, and terminates by its 
contents being absorbed, or hj a drying up of the contents; or 
else it breaks, leaving a thin, brown scab, which falls after some 
time. 

The different kinds are classified into one, which is irregular 
in form and distribution ; and another, which shows a circular ar- 
rangement of the clusters, 

A sense of heat, tingling, or smarting precedes ; then red points 
are to be seen ; the redness increases in the course of a day, and 
then little bladders, filled with a transparent serous or watery fluid, 
succeed. On the third day, the fluid becomes turbid, and then the 
vesicles shrink, when, at last, thin, brown scabs form, to be thrown 
off in scales by the twelfth day. The redness and discoloration of 
the skin slowly disappear. Sometimes ulcers are left ; but they are 
superficial. Languor, thirst, and loss of appetite may attend. 

Herpes may be met with on the lips, the eyelids, nose, or ear, 
and on the foreskin. 

Circular kinds of patches are seen of various sizes, seldom ex- 
ceeding the size of the palm of the hand. They are of a vivid red 
color, and the numerous vesicles run together. These patches run 
through their course in about ten days ; but they may appear in 
succession, become chronic, and continue for weeks. The face, 
neck, chest, Snd arms are the chosen site. 

In another form the patches are circular or oval, vividly red, but 
becoming pale in their centers, the vesicles being developed on the 
outer margins of the patches, the size of which increases by an 
extension of the circumference. The vesicles go through similar 
changes with those above described, and fall off in nine or ten days, 
leaving a red skin, or they may form and fall off in dry scales. 

This eruption is only dangerous when it is the sign of some in- 
ward complaint, or when it occurs in old people ; for gangrene is 
then apt to take place. It has been of service in some constitu- 
tions, by preventing an attack of consumption. In such cases, be- 
19 



290 AMEKICAN HOUSEHOLD BOOK OF MEDICINE. 

ware of what is called driving it in bj cold applications, astringents. 
Persons so situated are known by being of delicate habit, by marks 
of debility, and susceptibility for disease. 

Treatment. — Gentle laxatives, sweating medicines, and diluents 
must be given ; but if febrile symptoms run high, bleed. 

A simple ointment to the patches ; and when the vesicles have 
burst, sprinkle with starch powder. When the eruption is acting 
as a counter-irritant, we should follow the indication by keeping 
up an irritation on the skin after the eruption has disappeared. 

If there is debility, tonic infusions of gentian, calumba, etc., with 
carbonate of soda or potash, twenty grains each, thrice daily, in 
one ounce of infusion. The acetate of potash, twenty grains, is 
useful, instead of the carbonate ; or they may be combined. 

For herpes on the lip, this ointment may be used : 

No. 123. Ointment of elder flowers 1 oz. 

Liquor of sugar of lead 1 drachm. 

Mix. 

When the eruption becomes chronic, the following ointment 
should be tried ; and if it fail, then a blister applied : 

No. 124. Sulphuret of lime 60 grs. 

Camphor in powder 15 grs. 

Hos's lard '. . 1 oz. 



Humid Scall, or Eczema. 

Non-contagious ; minute vesicles in great numbers, often run- 
ning together ; the inflammation of irregular form, and mostly 
spreading over a considerable surface. The little bladders are 
often so close to each other, that one great vesicle is formed. 

The vesicles terminate by drying up, or by ruptune and forma- 
tion of scales, and the acute kind lasts from a week to a month. 

Eczema is acute or chronic. 

Causes. — Spring and autumn, and the female sex predispose. 
Exposure to intense heat, irritation of the skin by a blister, fric- 
tion with mercury, the handling of dry powders, as flour, sugar, etc. 

This may be mistaken for itch. 

Treatment. — Aperients, cooling drinks, simple diet, warm baths^ 
and warm dressing. According to the degree of infliammation or 
fever, our remedies should be proportioned. 

A decoction of goosegrass, the gaUum aparine, has been much 



THE CHRONIC ECZEMA. 291 

praised. One ounce to a pint and a half of water, boiled to a pint. 
Drink half a pint to a pint daily. 

The distressing itching or smarting is best relieved by a lotion 
of three grains of cyanide of potash to one ounce of water. Sul- 
phur and greasy applications are to be avoided. 

The Chronic Eczema 

often follows the acute, and is a very intractable disorder. The 
skin becomes highly inflamed, and is marked by fissures at the 
joints. In some cases, so much acrid discharge exudes as to cause 
the clothes to stick to the skin ; in others, there is a surface, cov- 
ered with shining crusts, and the itching is intense. Grocers, and 
other tradesmen who handle irritating powders, suffer from this 
scall — forming grocers' itch on the backs of the hands. 

Eczema may be transmitted from one person to another, by 
means of the discharge from the vesicles ; but it is still not con- 
tagious, the discharge acting merely as a local irritant. 

Treatment. — As eczema acts very often as a safety-valve to the 
health of the patient, we must check the discharge very cautiously, 
and, indeed, not before a counter-irritation on the skin, elsewhere, 
or in the bowels, have been established. 

The eruption is difficult of cure when there is a coexistent state 
of disease within the body ; because, we must first remove the con- 
stitutional affection, when the eczema would soon disappear almost 
without medicines, and, as it were, of itself. 

The redder the skin, the more we should lean to a lowering 
plan — active aperients ; then carbonate of soda or potash, three 
times a day ; vapor baths ; vapor douche ; sulphureous baths — 
three ounces of sulphuret of potash in enough water for a bath. 

The itching must be allayed, for it prevents sleep. 

No. 125. Hydrocyanic acid J to -J oz. 

Alcohol J oz. 

Distilled water 7J oz. 

Sugar of lead 16 grs. 

Mix. 

Or this ointment : 

No. 126. Cyanide of potash 12 grs. 

Oil of almonds J oz. 

Ointment of white wax 2 oz. 

Mix. 



292 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

My plan of treatment is, to begin with calomel and colocynth 
pills — two at night — and next morning the salts and senna mix- 
ture, or a seidlitz powder. Then I give 

No. 127. Acetate of potash 20 to 30 grs. 

Syrup 1 or 2 drs. 

Water, or infusion of gentian 1 oz. 

Thrice daily, and long-continued. It soon alters the urine for 
the better, increasing its quantity. 

The itching is to be allayed as above directed. 

To show what benefit is derived from aperients, I will mention 
a case which lately occurred. A lady had suffered annually from 
eczema, and had sometimes been confined to bed for six or seven 
weeks at a time. Her doctor, who seldom or never ordered medi- 
cines in any case, told her to apply poultices, to take no medicine, 
and to wait for warm weather. The poultices increased the itch- 
ing, and, dissatisfied with this treatment, she consulted me, and I 
prescribed. 

By mistake the druggist ordered the calomel, etc., pill to be taken 
every four hours, and the aperient mixture between the doses. 
For some twenty-four or thirty hours the bowels were in incessant 
action, and inflammation might have been induced. 

I visited her forty-eight hours after the prescription, and found 
that the redness of the skin had quite disappeared, and the itching 
was gone. In three weeks a cure was nearly complete. 

"Where we have reason to suspect internal disease, the eruption 
must not be dried up without giving repeated purgatives, and using 
counter-irritants — as croton oil liniment, and in some cases it would 
be better not to attempt a cure. 

Miliary Eruptions — Sudamina, or Millet-seed Kash. 

Round, prominent vesicles, about equal in size to millet-seed — 
transparent at first, but, in twenty or twenty -four hours, opaque, 
resembling pearls scattered on the skin. There is a profuse sweat 
of a sour, rank odor. They continue two or three days ; shrivel 
and form thin scabs; some fever. They are always associated 
with excessive heat of the skin, and often with profuse perspira- 
tion ; and hence they are occasionally met with in measles, scar- 
let fever, and small-pox. Used to be of frequent occurrence in 
former times. 



CRUSTED TETTER OR SCALE— IMPETIGO. 293 

Causes. — Anything debilitating — excessive discharges, irritation 
in stomach and bowels. 

Great dejection of mind, and prostration sometimes attend; and 
little dark spots, like flea-bites, are interspersed in bad cases ; 
vomiting, difficult respiration, convulsions, intermitting pulse, ^nd 
dropsical swellings accompany fatal cases. 

Treatment. — Diminish immoderate heat and sweating, by cold 
cautiously applied, by gentle aperients, and by the mineral acids ; 
the dilute sulphuric acid, ten to fifteen drops in infusion of roses, 
or with quinine, one grain. 

Support the strength by ammonia — bark and wine — and wherever 
restlessness requires it, give opium. If the eruption should unex- 
pectedly disappear, and inward suffering follows, the warm bath, 
musk, camphor, opium, and blisters. 

Running, or Crusted Tetter or Scale — Impetigo. 

Clusters of small pustules (vesicles with yellow fluid in them) 
raised a little above the skin; they burst in two or three days, and 
the discharge hardens into thick yellow, brownish-greyish tr^s- 
parent crusts. The scabs rest on an inflamed base, of irregular 
shape, and are moistened by the discharge. Successive crops often 
appear, and the disease lasts from three or four weeks to as many 
months, or even years. 

Causes. — Spring and autumn predispose; so does childhood or 
the scrofulous temperament. Errors in diet, impure air, want of 
cleanliness, etc. Not contagious. It is unattended with danger. 

Treatment. — If high excitement be present, a full pulse, head- 
ache, and fever, then blood-letting or leeches near the seat of the 
disease. Low diet and saline drink. But, in less severe forms, 
tepid baths, vapor douche, with tepid aperients. 

I would treat this just as I would treat eczema. 

Here the decoction of the galium aparine, or goosegrass, must 
be tried. (See Eczema.) 

For the troublesome itching : 

No. 128. Hydrocyanic acid, dilute 4 oz. 

Alcohol i oz. 

Hose water. 7 oz. 

Make a lotion. 

Acetate of lead, fifteen grains, may be added. 



294 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

In chronic cases, alkaline lotions to the skin, tepid baths, the 
dilute acids, or lunar caustic, may be applied ; stimulants. 

When the head is attacked, crop or shave ojBf hair ; then vapor 
douche, and water dressing. 

Papulous Scall — Ecthyma. 

An eruption in distinct inflamed circumscribed spots, which be- 
come of a considerable size ; pustules form on the center. In two 
or three days these dry up, leaving thick scabs behind them, and 
when they fall off, the skin underneath is purple. In bad cases, 
there are left unhealthy ulcers. Pain and slight fever may accom- 
pany. Grocers, brick-layers, etc., are subject to this. 

Treatment. — Gentle aperients, wholesome food, alkaline baths, 
sea-water baths, caustic to ulcers, oxyde of zinc ointment, tonics, 
quinine with sulphuric acid, infusion of gentian with carbonate or 
acetate of potass. 

Lichen, o^ Dry Pimples. 

An eruption of small, hard pimples, sometimes of the color of 
the skin, sometimes red, arranged in patches or clusters, with se- 
vere itching. It is usually a chronic disorder. 

It terminates in small scabs falling off. 

The lichen strophulus forms the red gum, white gum, or tooth- 
rash of children ; but lichen attacks grown-up persons. The causes 
are an abuse of spirits, handling dry powders, grief, disorder of 
stomach. 

This disease is not contagious, nor dangerous ; but is difficult to 
cure. 

Treatment — According to symptoms. Lower the system, if it is 
too high, in the usual way. 

Chronic cases require stimulants. Ointments of biniodide of 
mercury, one drachm to one ounce of lard. 

Sulphur and iodine vapor. 

The prickly heat of tropical climates is a species of lichen. 
The pricking, itching, and tingling are almost terrible to bear, 
though it is better to bear them. No remedies have availed much. 
At Sierra Leone the negroes rub the juice of the lime upon the 
skin; of little use. Cold sluicings, useless. Light clothes, open 
bowels, avoiding exercise in open day, strict temperance in eating 



PRURIGO. 295 

and drinking, vvith a determined resolution to resist the first at- 
tacks with stoical apathy, form the best and only mode of com- 
bating this troublesome foe. 

In all kinds of lichen a moderate cooling regimen should be ob- 
served, and all stimulants avoided. Treat and lower according to 
state and symptoms. A weak lotion of acetic acid and watef, or 
vinegar and water, for the itching ; avoid warm baths. When 
chronic, use this ointmeM : 

No. 129. Calomel 1 dr. 

Powdered camphor 20 grs. 

Lard ► . . . . 1 oz. 

Mix. 

Prurigo 

is a chronic and non-contagious eruption, characterized by pim- 
ples larger than those of lichen, not differing in color from the in- 
tegument, and attended with an excessive and burning itching ; when 
scratched, the pimples become covered with small black scabs, and 
when the pimples decline, they leave yellowish stains behind them; 

The itching is tormenting, and has been compared to burning fires. 

Treatment. — For this obstinate disease, daily alkaline or sulphur 
baths, of seventy degrees of heat ; or, if these irritate, a simple 
soap bath. 

This liniment has been used with benefit : 

No. 130. Croton oil J to 1 dr. 

Oil of almonds 1 oz. 

Several topical remedies against the itching should be at hand 

in the night. 

Mons. Giherfs Ointment. 

No. 131. Hydrate of lime 2 drs. 

Subcarbonate of soda ) o -i i i 

T J V 01 each f dr. 

Laudanum j ^ 

Lard 1 oz. 

Mix. 

3Ions. Alibert's Ointment. 
No. 132. Laudanum 



Q -, ,. J 1 -L r of sach 1 dr. 

bublimed sulpnur j 

Oxyde of zinc 1 dr. 

Oil of almonds 1 oz. 

Lard 3 oz. 

Mix. 

Laxative medicines, diuretics (increasing flow of urine), acid 



296 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

tonics, etc., with light, cooling diet, avoiding all stimulating food 
and drinks. 

This disease is often accompanied by lice, when a wash of bi- 
chloride of mercury must be used. 

Leprosy, or Lepra. 

A non-contagious, chronic inflammation of the skin (dermis), 
and the eruption consists of raised and circular patches, which are 
speedily covered by thin, semi-transparent scales of white upper or 
scarf-skin. The patches are prominent round their circumference, 
and depressed in their center, and they increase by an extension 
of the circumference, while the center returns to the natural state. 

The scabs are thrown off, and replaced by successive formations. 

Causes. — Autumnal season ; male sex predispose ; while irritation 
of the skin, strong mental emotions, salt meat, all debilitants are 
exciting causes. 

Treatment. — Cure very difficult ; quietude ; a cooling, unexciting 
regimen, and bathing are chiefly to be relied on. 

I have met with success from giving the acetate of potass, and 
would try the goosegrass decoction, twenty -five pr thirty grains in 
three or four ounces of decoction, thrice a day. 

Mercury and iodine combined, in form of biniodide of mercury, 
from one-sixth to one-fourth of a grain, seem to exert almost a spe- 
cific influence over the morbid state of the skin, according to the 
late Dr. A. T. Thompson. 

He also gave the iodide of arsenic, one-tenth of a grain, gradu- 
ally increased to one-third of a grain. But this remedy requires 
close watching ; so that when heat of mouth and gullet, anxiety at 
the pit of the stomach, or pain and gripings are complained of, dis- 
continue it. Quickness and hardness of the pulse, with slight puffi- 
ness of the lower eyelids, show that arsenic is beginning to act no 
longer as a remedy, but as a poison. 

Tar has been recommended, and Mons. Lemery orders an oint- 
ment which cured eight patients out of fourteen, in from five weeks 
to three months : 

No. 133. Napthaline 2 to 4 parts. 

Lard 30 parts. 

Mix. 

Apply on folds of linen, night and morning. 



dry tetter, or psoriasis. 297 

Dry Tetter — ^Psoriasis. 

This is a chronic, non-contagious inflammation of the skin. 
Patches are seen of irregular size and form, covered by thin, irreg- 
ular, whitish scales of dried scarf-skin. The patches are raised 
above the level of the skin, flat upon their surface, or somewTiat 
more raised at their centers than at their circumferences, and deep 
chaps or fissures intersect here and there. Spring and autumn are 
the seasons favorable to this complaint. Bakers and washerwomen 
sufi'er from it, forming what is called baker's itch, washerwoman's 
itch. 

In some of the kinds, there is a troublesome itching, which al- 
ways occurs at night. 

Treatment. — This is a troublesome, intractable, and, in the in- 
veterate form, an incurable disease. 

The treatment is much the same as that applicable to psoriasis. 
"Various remedies have been extolled as almost specifics, and just 
now the goosegrass or galium aparine is loudly talked of. (See 
Eczema and Psoriasis.) 

Dandriff, or Pityriasis. 

This consists of a chronic superficial inflammation of the skin, 
with desquamation, or scaling off, to a great extent, the scales being 
constantly renewed. All parts may be attacked, but the head 
most frequently. Itching, at times slight; at others, severe. It 
is caused by irritation of the skin by heat, a strong sun, or by 
chemical or mechanical irritants. 

The abundant branny scales on a number of small circular patches, 
of a red, yellow, or black color, distinguish this from all diseases 
of the skin. 

Treatment. — No danger to be feared; but it is usually difficult 
to cure. 

Cleanliness, tepid baths, tonic medicines, blue pills, the gray 
powder, as an alterative — three grains, every night, of either are 
sometimes necessary. The ointment of nitrate of mercury, called 
also citrine ointment, and which can always be procured of an 
a,pothecary, should be tried. To allay the itching, the cyanide of 
p<^tash, or the hydrocyanic acid, as before recommended. 



298 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Itch, or Scabies. 

Tills eruption is usually met with between the fingers, or on the 
wrists, the inside of joints, and at the bends of the joints. It is 
characterized by scaliness of the scarf-skin, by vesicles, or by what 
are called pustules — little bladders filled with a yellow fluid called 
pus. The itching is very great, and it is increased by warmth, by 
stimulating food or drinks. The scaliness is said to be owing to 
the burrowing of a little creature, or animalcule, called the itch in- 
sect, which burrows beneath the outer skin, and which excites irri- 
tation. 

The vesicles are few and scattered, bearing no proportion to the 
number or site of the animalcules. They are more or less conical 
or rounded, according to their situation, and the fluid in them dif- 
fers in color and consistence. If we look at an early vesicle, a 
spot may be observed on its surface. Here the insect enters ; and 
from this spot a white line, straight or curved, may be traced, of 
varying length, up to five or six lines. At the end of this line, 
which is the burrow of the acarus, the minute insect is to be found. 
Yet the acarus is never situated within the vesicle nor within the 
pustule, and there is no communication between the vesicle and 
the burrow. The eruption and the itching are in proportion to 
the vigor of habit in the afi'ected person. The more debilitated the 
person, the slower the progress of the eruption, and the less vio- 
lent the itching. 

It is of importance to know when a case of itch is before us ; 
for eczema, prurigo, and lichen may resemble it rather closely. 
The itch is known, first, by a peculiar scaliness and undermined 
state of the outer or scarf-skin ; secondly, by the conical vesicles, 
with needle-shaped and transparent points ; and, thirdly and prin- 
cipally, by the presence of the itch insect, which may be extracted 
from its retreat by means of a sharp instrument in an experienced 
hand. 

Itch never attacks the face. 

The period at which the vesicles appear, after exposure to con- 
tagion, varies with the state of health and the age of the subject, 
and the season of the year. In strong, healthy children, the ves- 
icles have appeared in two days after contact, the ordinary period 
being four or five days, which in weakly subjects may be further 
postponed. In adults, the period is a week or ten days ; or, ia 



FISH SKIN, OR ICHTHYOSIS. 299 

winter, a fortnight or three weeks. In old persons the period is 
still longer. 

The period of duration of the itch is usually a week or ten days, 
but it may continue for months. 

Treatment. — To effect the cure in the shortest possible time, the 
skin must be prepared by a thorough ablution, with a warm solu- 
tion of sub-carbonate of potash, containing about half a pound of 
alkaline salt to a gallon of water. The best preparation is the 
compound sulphur ointment, of which * grown-up person should 
rub well four ounces into the skin, before the fire, and into the af- 
fected parts — especially morning and evening — for two days. 

A child would require half the above-stated quantity. 

On the morning of the third day, a warm bath, and wash the 
skin thoroughly with plenty of soap, when the cure will be com- 
pleted. 

The compound sulphur ointment may excite much irritation ; 
then, if time is not of importance, recovery may be effected in a 
week, by mixing one ounce of sub-carbonate of potash with a pound 
of the simple sulphur ointment. 

Some soapy compounds have been recommended. 

No. 134. Sub-carbonate of potash 2 drachms. 

Water 1 oz. 

Olive oil 2 02:. 

Camphor 2 drachms. 

Sublimed sulphur 5 oz. 

Mix. 

No. 135. Sublimed sulphur ") « ,-, , 

White soap. I "^ ^''"^ 4 I"'"°'J- 

These do not soil the clothes. 

In young children and in families, when the odor of the sulphur 
is particularly objected to, the following has been found effectual in 
eradicating the disease : One drachm of camphor, dissolved in one 
ounce of oil. 

The clothes, bedclothes, etc., should be disinfected by exposure 
to the fumes of sulphureous acid gas, or they should be destroyed. 



Fish Skin, or Ichthyosis. 

A number of small, hard, thick, and dry brown scales, overlap- 
ping each other like the scales of a fish, form on the palms of the 



300 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

hands, the soles of the feet, the face, eyelids, limbs, and around the 
joints. There is no accompanying inflammation, pain, nor itch- 
ing ; but there is a disagreeable odor. 

Causes — Obscure, hereditary ; the person is generally born suf- 
fering from it. When hereditary, it is incurable, and always very 
obstinate of cure. No danger to life. 

Treatment, — Yapor baths ; strong stimulating applications to the 
skin ; blisters, caustics, the vapors of sulphur and iodine. 

Internally, arsenic, or ffiie iodide of arsenic must be given. (See 
Leprosy.) 

Warm alkaline baths are essential, containing the subcarbonate 
of soda, which dissolves the albumen, and softens the hardened 
crusts. 

Corns. 

A corn is an increased thickness of the outer or scarf-skin, 
caused by undue pressure. Corns may be divided into laminated, 
fibrous, and soft corns. 

The laminated corn arises from continued pressure, producing 
a congested state of the skin ; in consequence of which the part of 
the skin called papillae elongates, the papillae in the center, where 
there is the greatest pressure, being longest of all. 

Fibrous corns are those on the summits of which there is an ap- 
pearance resembling the ends of fibers, and if the top be cut off 
horizontally, these vertical fibers seem as though they were cut 
across, giving rise to the belief of roots or cores to the corn. 

These so-called roots are merely the center papillae, which are 
elongated, and by the pressure on the center of the corn, are bent 
and doubled down. 

Soft corns are very painful and annoying, and more so than the 
two preceding kinds. They are seen between the toes ; are always 
of small size ; are not convex ; and, from being constantly im- 
mersed in the perspiratory secretion of the part, they are soft. 

Causes — Are pressure and friction, from boots being too small 
or too large. In the first two kinds, the pressure is directly ver- 
tical, while in soft corns it is pressure of the toes against each 
other. 

Corns may be seen on the feet, on the hands, or on the knees. 

Treatment. — Curative or palliative. The first, says Mr. Wilson, 
in his excellent account, consists in the removal of the cause; the 



WARTS. 301 

Other in the removal, from time to time, of portions of the thick- 
ened scarf-skin. 

Rest, avoidance of tight boots. 

Plasters spread upon spunk, or on thick leather, and cut out 
in the center, so as to remove pressure. One bit of plaster should 
be placed over another, or with holes of proper size cut in tbeir 
centers, until enough are placed to prevent pressure. 

The palliative treatment comprises the removal of the corns 
either by scraping or filing, after the corns have been well soaked 
and softened in an alkaline solution, or by cutting in the hard or 
soft state. 

A certain oure for corns has been proposed, and it is thus com- 
posed: 

No. 136. Tincture of iodide J oz. 

Iodide of iron 12 grs. 

Chloride of antimony li oz. 

Mix. 

The chiropodists remove the central part of the co.rn, leaving a 
raised line of circumference as a circular cushion of protection. 

Caustic is often applied; or by plasters containing the solvents 
of albumen, soda, and potass. 

Dr. F. J. Brown has proposed an effectual remedy of getting rid 
of a corn by enucleating it, which he did on his own person. He 
says the corn is seated in a cup-like depression of the true skin, 
as is a stone in a brooch. His method is to pass a penknife ver-: 
tically around the corn, for the full depth of the indurated cuticle, 
in the situation of the marginal line. The true skin is not wounded 
nor any blood spilt ; and the corn may be turned out bodily, leav- 
ing the true skin perfect. The depression soon fills up. 

Entire .removal is the only cure for the soft corn ; and their for- 
mation may be prevented, and when present they may be rendered 
bearable, by daily ablution with soap, and by placing a piece of 
cotton wool between the toes after each ablution. 

Many advise bathing or washing the feet with spirits and water. 
Corns may produce bunions ; or, when seated on joints, they often 
excite inflammation about the articulations. 

Warts. 

depend upon the state of the papillae of the true skin. They may 
be developed at any period of life, and arise without any apparent 



302 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

cause, to continue for the rest of life, or disappear unexpectedly ; 
most frequent in children. 

Caustic, or nitric, or strong acetic acid removes them, or any 
strong stimulant. Electricity disperses them ; sparks must be sent 
through them for five minutes daily, and they do not reappear as 
they do when removed by other means. A strong decoction of 
galls may be applied. In a few days, or a week, this decoction will 
most effectually remove them. 

Purpura — Land and Sea Scurvy. 

This is known by the effusion of blood under the skin and into 
other parts, forming patches of various size in considerable num- 
"bers. It was divided into three kinds — the simple, the hemor- 
rhagic, and the sea-scurvy. 

The simple begins with uneasiness or slight giddiness; then an 
eruption of small round patches, of a dark red color, mainly on 
the thighs and legs, but also in any part of the body. 

After a few days the first patches begin to fade, and new ones 
appear ; the general health is not disturbed, and the disease may 
last from three or four weeks to as many years. 

The causes are not well known. 

Treatment. — Tonics, combined with a nourishing diet; mild aper- 
ients now and then. The object is to restore tone to the system. 

The hemorrhagic form is marked by weariness, weakness ; inap- 
titude for any exertion, bodily or mental; pains in the limbs, and 
patches like the above described, only larger; sometimes large 
vesicles filled with liquid blood ; the gums are swollen and spongy; 
blood is discharged from the gums and other mucous membranes ; 
the legs are stiff from the effusion of blood between the muscles ; 
pulse feeble, sometimes full and hard. 

A relaxed state is at the bottom of this disorder, and the cap- 
illary vessels are weakened, while the blood itself is altered from 
its usually healthy state, and its consistency is diminished. 

A moist atmosphere ; a scanty, improper diet. Long-continued 
difficulty of breathing, as in chronic bronchitis, will produce such 
a state. 

Treatment. — If the pulse is full and hard, a small bleeding to 
eight or ten ounces ; then tonics, a generous, nutritious, and mixed 
diet. 



SEA SCURVY. 303 

If debility be urgent, tonics and stimulants ; turpentine will often 
do good. A table-spoonful of lemon-juice three or four times a day. 
Potatoes to be eaten. 

Sea Scitrvy. 

Heaviness, weariness, dejection of spirits, anxiety, oppression 
at the pit of the stomach, are followed by sallow and bloated 
countenance, hurried respiration, looseness of the teeth, spongy, 
bleeding gums, offensive breath; old wounds, long since healed, 
break out afresh ; severe wandering pains are felt, at night par- 
ticularly; the skin is dry; urine small in quantity, turning biuo 
vegetable infusions of a green color ; the pulse is small, frequent, 
and at last intermitting. The intellect remains clear. 

In the last stage, the joints swell and become stiff; the tendona 
of the legs are rigid and contracted; general emaciation ensues, 
and discha.rges of blood from many parts, and fetid evacuations, 
terminate the scene of suffering. 

Although the terms sea and land scurvy are used by many per- 
sons, yet there is no difference in the diseases, except as to degree. 

Causes. — Fatigue, hardship, and w^hatever debilitates, engender 
a tendency to scurvy. Exciting causes are improper diet, espec- 
ially salt meat and biscuits, a deficiency of vegetable food, and 
of those articles of food which contain vegetable acids. 

The patient will recover if there is little reduction of strength, 
and there has been no previous attack, of scurvy ; if the skin be 
moist ; if flea-bite looking spots appear, when they are of a red 
and not of a dark color. But great prostration, extreme oppres- 
sion, red eyes and flushed face, a rapid and weak pulse, profuse 
hemorrhages, spots of a dark livid color, fetid and involuntary 
evacuations, all denote an unfavorable result. 

Treatment. — Medicines are little wanted, when compared with 
diet. Vegetable food ; the orange, lime, and lemon, or the citric 
acid, as w^e use it in effervescing draughts. It is very convenient 
to carry, and as fresh fruit is often not to be got, the citric acid 
removes the difficulty. 

If there is great prostration, tonics and stimulants ; fermented 
liquors, ale, cider, spruce beer, infusion of malt, fermenting wines ; 
the subacid fruits, sugar, molasses, potatoes. 

Aperients occasionally. Cream of tartar, or sulphates of mag- 
nesia or soda ; infusion of tamarinds. 



804 AMERICAN HOUSEHOLD BOOK OF. MEDICINE. 

Eor ulcerations of the gums, astringent gargles of alum, sul- 
phate of zinc, decoction of bark, etc. ; honey of borax painted on 
the gums is serviceable. 

Acute pains are relieved by opium; and the oppression at the 
chest, and difficulty of breathing, by stimulants — the nitric and 
sulphuric ether, with camphor ; for contractions and stiffness of the 
muscles of the legs, fomentations, friction, etc. 

The great point is precaution, by a due admixture of vegetables 
with a due proportion of vegetable acids — ^lemon-juice or citric acid. 
The potato is one of the best vegetables. Potatoes, raw and sliced, 
are excellent anti-scorbutics. They should be peeled like cucum- 
bers, and eaten with a little vinegar. Pumpkins and plantains 
are useful, but not so good as potatoes. Potatoes, it is said, are 
equally good boiled as raw; or, at all events, boiled potatoes will 
act as preventives. 

The cold bath, friction with flesh-gloves, plenty of good air, ex- 
ercise, and good food will fortify against the attacks of purpura 
or scurvy. 

iTCHiNa, OR Pruritus. ' 

This itching is excited by the most trivial causes, and may con- 
tinue for hours, depriving the patient of comfort or rest. As soon 
as dinner has been finished, or any stimulus has been taken, the 
tormentirjg itching begins. The warmth of the bed brings it on, 
and the morning is the only time when the itching ceases to annoy. 

Scratching does not relieve, but augments the evil. But if the 
mind be- engrossed with any agreeable occupation, and is diverted 
from dwelling on the itching, then the morbid sensation is for the 
time inactive ; it rages again the moment the mind reverts to the 
itching. The attacks of pruritus are variable as to duration ; they 
sometimes continue for hours without any amendment ; at others, 
their periods are shorter. The disease may last for months, or 
even for several years. 

It is the sign and consequence of some irritation in the mucous 
membranes of the body ; sometimes in that of the stomach and 
bowels ; at others, in the lungs ; and in others, in the genito-uri- 
nary passages. It is situated in various parts of the body. 

Treatment. — This must be general or local, or both. 

By the first, we must regulate the secretions, if there is debility, 
tonic or bitter infusions, with sedatives, such as 



GRUBS, WORMS, COMEDONES. 305 

No. 137. Infusion of gentian compound 6 oz. 

Bicarbonate of soda 2 drs. 

Hydrocyanic acid 5 drops. 

A fourth part two or three times a day. 

The diet must be light, nutritious, and easily digestible, avoid- 
ing any thing stimulating. 

The local treatment, vinegar and water, or lemon-juice and 
water. When the itching is violent at the lower boAvel, we must 
ascertain whether there are piles or fistula, or thread-worms, and 
act accordingly. A lotion of vinegar and water, of tincture of 
opium and water, will often relieve ; so will a lotion of sugar of 
lead, or of sulphate of zinc; and brushing the parts over with 
Eriar's balsam (tincture of Benjamin) gives marked relief — the 
last especially. 

The itching that attends the urinary passage, in male and fe- 
male, depends on some irritation of a neighboring part, which must 
be sought and prescribed for. 

This itching is one of the most annoying and severe disorders to 
which man can be liable. 



Grubs, Worms, Comedones. 

The sebaceous glands of the skin are glandular organs in a bag- 
like form, which are embedded in the true skin ; and the ducts or 
outlets of these glands either open on the outer skin, or they ter- 
minate in the follicles of the hair. In grubs, the sebaceous secre- 
tion is thickened, and produces distension of the hair follicles, inta 
which it opens. When it reaches the mouth of the follicle, the 
secretion hardens, becomes deeper in color, and, at the same time, 
from being exposed to the dust and dirt of the atmosphere, the ex- 
tremity is rendered dingy and dark-colored. This discoloration of 
the sebaceous substance, at its extremity, gives rise to the appear- 
ance of a round black spot. Thus says Dr. E. Wilson, and con- 
tinues : If a fold of skin, including one of these spots, be pressed 
between the fingers, the concreted secretion is squeezed out, about 
a line in length, and blackened at its extremity, making it look 
like a worm. 

This secretion is sometimes hard and concrete, instead of being 
Boft ; it then looks like horn, and might require to be removed by 
a pair of ciliary forceps. 
20 



306 AMERICAN PIOUSEHOLD BOOK OF MEDICINE. 

This disorder of tlie sebaceous glands is commonly met with on 
the face of persons in whom the cutaneous circulation is less active 
than natural — and particularly among the inhabitants of cities and 
large towns, in whom the brain and nervous system claim an un- 
due proportion of the vital energies, and in whom fullness of the 
internal organs is not unfrequent. It is met with as an accompa- 
niment of acne, or blotched face. 

Treatment. — The skin must be stimulated gently ; rub gently 
with soap ; then wash well; then rub briskly with a rough towel, 
until the skin begins to glow. This to be done twice a day. 

A red, patchy state ensues at first; but it speedily passes away. 

Cold bathing and sea bathing, and this lotion : 

No. 138. Bichloride of mercury (corrosive sublimate) 2 gr. 

Eau de Cologne , . 2 oz. 

Distilled water 6 oz. 

or the same quantity of the bichloride to half a pint of emulsion 
of bitter almonds. 

There are other sebaceous accumulations^ forming swellings, 
more or less large, and out of some of them a horny matter would 
exude. 

The treatment may be collected from what has been already 
said. 

Acne, or Copper Nose. 

This is a chronic inflammation of the sebaceous glands, and of 
their excretory hair foHicles. There is an eruption of hard, coni- 
cal elevations, distinct from each other, of moderate size, and more 
or less red. The tops become yellow and burst, while the bases 
remain in an indolent state for some time before they finally dis- 
appear. 

This prevails during the middle period of life, up to old age. 
It may be developed on all parts of the body ; but is more fre- 
quent where the skin is thickest, and where the parts are exposed 
to the air. 

Acne is divided into a simple form and a rosaceous form. 

The primary form is a hard, red pimple, most commonly on 
nose, cheeks, temples, and forehead ; also on back, the neck, and 
shoulders. The rosaceous form is most frequently met with in 
old persons, especially females, and its common seat is nose and 
cheeks. The color is a rosy tint; but this changes to a violet* 



SYCOSIS, OP. BARBEHS ITCH. 307 

In extreme cases, tlie veins enlarge, and the skin around becomes 
hardened. One kind of acne is called pointed, or spotted, from a 
small black point which forms at the top of each pimple. 

The indurated and rosy kinds of acne are not susceptible of 
cure, but may be much alleviated. 

Causes. — Hereditary tendency, indigestion, excess in eating or 
drinking, disorders of the womb, change of life, irritating sub- 
stances to the skin. 

Treatment. — In young and full-blooded people, lower the diet, 
avoid all stimulants, give gentle aperients — lotions of spirit, or 
sugar of lead. 

In the indurated kind, rub with an ointment. 

No. 139. Iodide of sulphur 20 grs. 

Lard 1 oz. 

or with a paste made of sulphur and milk. 

We may apply dilute acids or caustic to the eruption, or a lo- 
tion consisting of two grains of bicyanuret of mercury to an ounce 
of distilled water. Apply by camel-hair pencil, and wash off with 
cold water. 

Alterative medicines may be given — two or three grains of 
blue pill ; one every night, for a few nights. 

A drop of creosote in a draught of one ounce of water and one 
drachm of mucilage, three times a day. 

In ihe rosaceous form, still more care as to diet, and abstinence 
from spirits, avoidance of hot fires, heated rooms, and mental ex- 
citement. For local applications, the vapor douche, and the oint- 
ment of bicyanide of mercury. 

Sycosis, or Barber's Itch. 

Redness, or itching, heat, and distension of the skin of the chin, 
lower jaw, or upper lip. which are followed by an eruption of small 
red points, which, in two or three days, ripen into distinct pointed 
pustules, each traversed by a single hair. 

In five or six days these pustules burst, discharge their contents, 
a yellowish fluid, not mixed with sebaceous matter, as in acne, and 
form thin brown scabs, which fall off, and are sometimes not re- 
newed. The disease terminates in from ten days to a fortnight, 
but successive crops may appear for a long time. 

A smarting pain attends the eruption; the beard falls off; and, 



308 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

in long-standing cases, the skin of the parts is covered with a tu- 
bercle, or hard, red elevation of the skin. 

Causes. — The male sex ; youth, spring and autumn predisposes ; 
while any irritants, heat, neglect of cleanliness will excite it. 

Cooks, founders, and smiths are subject. 

Treatment. — Poultices are best; or warm fomentations, gentle 
aperients, and diluent drinks ; but if the disease is severe, we must 
lower the food, and keep the bowels more open. Every hair must 
be cut off singly with flat curved scissors ; and if they are loose, 
pull them out. 

Poultices of marshmallow root and potato flour laid on tepid. 
In obstinate cases, a more healthy blood must be formed, and 
chalybeates given. 

No. 140. Citrate of iron | dr.=30 grs. 

Infusion of calumba 6 oz. 

A sixth part twice or thrice a day, with occasional aperients. 



The Hair — Baldness. 

Baldness may arise from defective development of the formative 
pulps of the hair, or defective circulation in them, or defective 
nutrition of them, or from disturbed circulation in the hair bulbs ; 
and the causes are, hereditary tendency, acute diseases preceding, 
certain diseases of the skin, mercury, syphilis, coffee taken in ex- 
cess, late hours, abuse of pleasure, and old age. 

The hair may fall off when the vital powers are directed espe- 
cially to one part of the body, as in some diseases — during preg- 
nancy, after very active purgation, in rheumatism and gout, and 
in consumption. 

Baldness is much modified by sex ; females are less subject than 
males, probably because there is more fat under the skin in them 
than in men. The scalp of bald persons is very thin, and eunuchs, 
who are generally fat, have remarkably long and permanent hair. 
It is well said that the very hairs of our heads are numbered; and 
no application can cause one more hair to grow than we are born 
to have, any more than we could cause an additional finger to 
grow. 

Treatment. — We must try to stimulate the circulation on the 
scalp. The head should be washed every morning with soap, and 
dried with a rough towel ; then brushing it with a hard hair -brush 



JAUNDICE, OR ICTERUS. 309 

until redness is produced ; then a stimulating application should 
be rubbed in for about five minutes. 

Hair Embrocation. 

No. 141. Eau de Cologne 2 oz. 

Tincture of cantharides 2 drs. 

Oil of rosemary ") « t.-iaj 

Oil of laTender \°^ ^^"^ ^^ ^'"'^^' 

Or this pomatum of Dupuytren's : 

No. 142. Purified beef marrow 1 oz. 

Acetate of lead (sugar of lead) ..... 1 dr. 

Peruvian balsam 3 drs. 

Alcohol 1 oz. 

Tincture of cantharides, ) o i. -.c j 

cloves, and canella. . . . . . | ^^ ^^^^ ^^ ^^^P^' 

Mix. 

Gibert recommends this : 

No. 143. Purified marrow 6 drs. 

Oil of sweet almonds 2 oz. 

Powder of red bark 1 dr. 

Mix. 

Repeated shaving is of service, the object of which is to con- 
fine the nutritive fluids to the formative structure of the pulp, till 
it shall be strong enough to form hair of a proper size and strength. 

Whatever may be wrong in the system must be corrected ; so, 
if there is debility, tonics ; and if indigestion exists, the proper 
remedies must be resorted to. 

Where it is desired to get rid of superfluous hair, the following 
depilatory ointment may be tried : 

No. 144. Slaked lime 2 drachms. 

Subcarbonate of potash 2 dr.achms. 

Hog's lard 2 oz. 

Mix. 

Or this powder : 

No. 145. Lime 1 oz. 

Subcarbonate of soda 2 oz. 

Charcoal in powder 1 dr. 

Mix. 

Jaundice, or Icterus. 

Languor and inactivity, with loss of appetite, are the first symp- 
toms ; then probably there is a bitter taste in the mouth ; a sense 
of uneasiness or pain in the right side, over the liver ; the white 



810 AMERICAN HOUSEHOLD BOOK OF M^IDICINE. 

of the eye and the whole surface of the body become of a yellow 
color, and the yellowness sometimes deepens into a green color. 
This is called green jaundice; the urine is high colored, and tinges 
linen dipped into it yellow; there is nausea, perhaps vomiting; 
there may be obstinate costiveness, or the reverse state of looseness ; 
but the stools are of a clay color, though they may be high-colored. 
In some rare cases, the sweat and saliva are yellow, and objects seen 
by the patient are tinged of a yellow color ; the pulse is slow, un- 
less there are local pain and constitutional disturbance, when it is 
quick ; and the skin will be hot and dry. In all the cases I have 
met with, there was an itching of the skin. 

It is generally believed that the various modifications to which 
the secretion of bile is subject have a powerful influence in im- 
pairing the digestive functions, and such modifications have given 
rise to the very popular term bilious disorders. This convenient 
term has been loosely applied, even by medical men themselves. 
Some apply it to those diseases of the digestive organs which are 
attended with an excess of bile ; others, again, to those in which 
there is a deficiency of bile, or an impure state of it; and many, 
under this term, comprise all derangements of the digestion, which 
are attended with any form of bihary derangement. To crown the 
misapplication of terms, impaired digestion and impaired biliary 
secretion are used synonymously, as if the secretion of the bile 
was the only condition upon which digestion depends. 

The secretion of bile may be diminished or too copious, or it 
may be rendered impure, or it may be impeded in its course. 

The only evidence of diminution in this secretion, where there 
is no evidence of mechanical obstruction, is that the stools are, 
more or less, pale, or are of a dull white or ash color. This is 
considered to arise from torpor of the liver, yet many cases are on 
record of suspension or diminution of bile secretion, where the liver 
has shown, post-mortem, no evidence of disease, and where the bile 
ducts have been empty. It has been supposed, to account for this, 
that the elements of the bile have not been separated from the bile, 
in the same way as the urine has not been secreted in suppression 
of the urine. In the former case, bile ; in the latter, urea, has been 
detected in the blood — both these acting as a poison, and giving 
rise to coma and similar head symptoms. Of excess of bile, we 
can show no incontestible evidence ; for a small quantity of bile 
may so color the evacuations by stool as to resemble copious biliary 



JAUNDICE, OR ICTERUS. 811 

motions ; yet, af'er death, evidence enough has been obtained in 
the diseased alterations of the liver. "When jaundice occurs, while 
there seems to be plenty of the bile in the stools, an excess is de- 
duced from those circumstances to exist. 

Vitiated biliary secretion may exist, and has been proved to do 
so, but there are no evidences during life. 

An impeded secretion does at times exist, there is no doubt ; 
and then the bile is reabsorbed into the system and gives rise to. 
jaundice. 

Dark or black stools have been considered to indicate an excess 
of bile — yet these may arise from a diseased irritation of the mu- 
cous membrane of the bowels — so, likewise, green stools are con- 
sidered to be bilious — yet, they too, depend more probably on 
diseased secretions thrown out from the irritated mucous mem- 
brane of the bowels; but when the stools exhibit a white color, it 
is generally in connection with jaundice, and may be considered 
as evidence of obstruction to the passage of the bile, and of its re- 
absorption into the blood. 

Where white stools have been observed, without the occurrence 
of jaundice, we may presume that the blood itself is deficient in 
the biliary principles ; for, if they depended on functional derange- 
ment of the liver, the bile would be reabsorbed, and so give rise 
to jaundice. 

Refer to the First Section — article Secretion — where the causes 
of bilious headache, etc., are discussed. 

Causes. — Any kind of pressure upon the excretory tubes that 
convey the bile from the liver to the bowel ; or these tubes, or 
ducts, may be obstructed within, as in the case of gall stones. 
Pregnancy is a cause; but then the jaundice disappears after de- 
livery; newly-born children suffer. Jaundice may be an accom- 
paniment of inflammation of the liver, acute or chronic ; mental 
emotions are not unfrequently a cause. A high temperature, 
too, may give rise to jaundice in those who go to live in warm 
climates. This effect of a high temperature has been explained 
by- some, who suppose that it depends upon a sympathy between 
the extreme vessels of the skin and those of the vessel which forms 
the bile (the vena porta) ; others suppose it to depend upon a con- 
nection between the liver and lungs, which enables one of these 
organs to perform in part the functions of the other. It has been 
found that the quantity of carbonic acid gas formed during the 



312 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

breathing, and expelled at every breath, is diminished by a high 
temperature, and by circumstances which lower the powers of life. 
Now, the excess of carbon must be carried oJBf by some other 
channel than the lungs ; and as bile is chiefly formed of carbon 
and hydrogen, an increased secretion of bile must guard the sys- 
tem against the superabundance of the carbonic acid gas. Hence 
the increased flow of bile in hot climates ; and hence the cause of 
jaundice arising from the depressing passions, fatigue, stimulating 
drinks, etc., which may act by diminishing the quantity of carbonic 
acid gas formed in healthy respiration. 

Treatment. — Leaving gall stones to be treated of hereafter, we 
should, in treating cases of jaundice, endeavor 1st, to diminish the 
secretion of bile when excessive; 2d, to increase it when deficient; 
3d, to correct it when vitiated, and 4th, to promote the excretion 
of the bile, and to remove or relax spasm. 

Now, the first indication can only be done by avoiding causes; 
that is, high temperatures, and by diminishing the quantity of ani- 
mal food. If an irritable state of the bowels be present, and should 
be irritating the liver to undue secretion, this state must first be 
removed. 

The second indication is effected by mercury, upon which medi- 
cal men depend to a certain extent, except in cases of gall stones, 
some thinking it acts as a specific on the liver, others, merely as 
a purgative. Mercury may be given often, and in small quantities, 
so as to touch gently the gums and mouth, or it may be given in 
large, purgative doses. 

If any symptoms of inflammation of liver, either sub-acute or 
chronic, remain or are present, cupping or leeches to the right 
side, where pain or uneasiness may be complained of, then 4 or 6 
grains of calomel, with 8 or 10 of jalap, may be given at night, 
and worked off next morning with salts and senna draught. Then 
small doses, either of calomel, 1 grain, or of mercury and chalk- 
pow^der 4 grains; every night, or night and morning, for some 
time, but, watch so as not to salivate. If mercury seem to disa- 
gree by exciting thirst or feverish symptoms — then ** 

No. 146. Socotrine aloes 3 grs. 

Hard soap 6 grs. 

Make two pills ; to be taken night and morning. If no signs of 
feverishness exist, we may give 



GALL STONES. 313 



No. 147. Compound infusion of gentian IJ- 



oz. 



Sub-carbonate of soda 15 grs. to 20 grs. 

tbirice daily ; and if much depression of spirits attend, add 15 to 
20 drops of sal volatile. 

Aloes is an excellent remedy in jaundice and in torpor of bowels 
from deficient bile, and it may be combined with taraxacum, -^ith 
quinine, etc., according to circumstances. 

The temporary defect of bile may be supplied by various bitters, 
occasionally united with rhubarb, aloes, and the like. 

I have often prescribed this : 

No. 148. Watery extract of aloes 10 grs. 

Dandelion 2 drs. 

Mint, or peppermint-water 6 oz. 

A table-spoonful every four hours. 

Dandelion, or taraxacum, is very useful, when there is no stom- 
ach disease co-existent. 

No. 149. Bruised dandelion 4 oz. 

Distilled water 1^ pints. 

Boil to a pint. 

Of this, 2 oz. may be given two or three times a day, with cream 
of tartar, 1 drachm, if the bowels are very sluggish ; if they are 
not, the bicarbonate, or carbonate of potash or of soda, 20 to 30 
grains, instead of the cream of tartar. 

These medicines are also well adapted to correct a vitiated secre- 
tion of bile ; as far as we know at the present of its morbid con- 
ditions. 

As to the 4th, that of relaxing spasm, opium is the chief, if not 
the only remedy ; but when the bowels continue costive, an emetic 
or two has often, by exciting the action of the muscles of the belly, 
etc., caused bile to flow into the bowel, when it would soon pass 
away by the bowels, or be made to pass away by any aperient. 

Gall Stones 

may be formed of thickened bile — being secreted too thick — or 
being detained in the bile ducts ; but gall stones may consist of 
what is called cholesterine, or of resinous matter, or of what is 
called picromel. 

Now, when gall stones are composed of such elements, we can 
only suppose that the cholesterine, etc., are contained in excess 



814 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

in the bile, or else, there is a deficiency in the bile of the element, 
on which the solution of the cholesterine depends. 

Gall stones may form in all parts of the biliary passages, but 
they all find their way to the bile ducts or to the gall bladder — • 
Inhere they grow larger — and if they are situated either in the 
duct of the gall bladder, bile may flow into the bowels ; but once 
fixed in the bile duct, which is common to the liver and gall blad- 
der, a stoppage of bile must ensue, and jaundice. 

These gall stones cause some painful symptoms as they pass 
along, though they have been formed in numbers, and remained in 
the gall bladder unknown and unfelt, and have only been discov- 
ered after death. 

Sometimes they occasion a dull pain, increased on motion or 
after taking food; but the pain attending the passage of a gall 
stone is often intense. It is usually seated in the pit of the stom- 
ach, extending to the back and the right side. The pains are like 
labor-pains, and intervals of comparative ease succeed the fits of 
pain ; but there remains a dull pain. 

This pain may be a mark of inflammation ; but then we should 
have fever and accelerated pulse, as well as tenderness on pressure, 
whereas pressure mitigates, so that the sufi'erer applies his hand to 
his stomach or rests his belly upon some hard substance. 

According to Dr. Pemberton, the more exquisite the pain, pro- 
vided the pulse is below 100 in the minute, so much the more 
confident we may be of gall stones being in the act of passing. 
After a time, vomiting usually comes on ; then we shall have ten- 
derness of the belly on pressure. 

The pulse is even slower than natural sometimes — generally un- 
affected ; shiverings, or rigors, as they are called, may set in, just 
as shiverings, at times, accompany the passage of a bougie up the 
urethra. 

When a large stone has once forced its way through the ducts, 
others pass more easily, and quantities are often got rid of easily 
enough. 

Sometimes a large concretion sticks in the bowels somewhere, 
and may give rise to serious symptoms. (See Ileus and Inflam- 
mation OF THE Bowels.) But as they pass out with the stools, 
we should look for them in the evacuations, by mixing the stool 
^vith water, upon the surface of which any gall stones will m.ost 
probably float, since they are lighter than water. They will not, 



GALL STONES. 315 

iiowever, float, after having been soaked for some time, and they 
do not always float when fresh from the gall bladder. We should, 
therefore, examine as early as possible, both for floating concre- 
tions, and for others, by pouring the fluid, etc., carefully ofi". 

These stones form most readily in corpulent persons, of seden- 
tary habits, who eat and drink well, sleep much, and neglect their 
bowels. 

Cattle, when shut up in stalls, are said to be subject to gall 
stones, and to lose the complaint when turned out to grass ; hence 
Yan Swieten deemed grass to be a good remedy for jaundice. 
Cattle shut up will not thus suff'er, if they are carefully rubbed, as 
a horse is groomed, whereby the skin is kept in a good state. 

Gall stones collect in great numbers sometimes ; and Dr. T. 
"Watson tells us he has heard of an instance in which upward of 
1,300 gall stones were taken from a human gall bladder after death. 

Treatment of gall stones. — What we want to efi'ect here is, to get 
rid of the mechanical impediment to their passage out, and also to 
ease suff'ering. 

Should pa;! at pit of stomach become tenderness, leeches or 
blood-letting. Our sheet-anchor, both in relieving spasm and pain 
together, is opium, in full doses. 

Those who are sufi'erers from gall stones should have constantly 
by them pills containing one grain of pure opium in each ; one to 
be taken as soon as pain comes on, and repeated once or twice in 
the course of two hours, if the pain require, and much more may be 
safely given, and is necessary. Pills are less likely to be rejected 
than draughts ; but neither pill nor draught can always be borne ; 
then opium, in injection — thirty drops of laudanum in a small 
quantity of warm gruel, and repeated when necessary. 

The warm bath is indispensable almost; but if it can not be 
procured, warm fomentations, mustard poultices, or the warm tur- 
pentine folds of linen, are to be applied. 

One or two drachms of the carbonate of soda to a pint of hot 
water, and large draughts of it taken, will procure alleviation at 
times, the alkali controlling acidity, and the hot water acting as a 
fomentation. With these draughts opium may be combined. 

As soon as the p?in is quelled, clear the bowels by aperients. 

To prevent the formation of these concretions, we must prevent 
indulgence or exposure to the causes favoring their formation. 
Corpulency must be combated (see Corpulency), luxurious or 



316 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

sedentary habits given up ; the patient should eat and sleep less, 
and walk or ride more. 

It is believed that the continued use of alkalies renders the bile 
less disposed to concrete ; so they may be given — twenty or thirty 
drops of liquor of potash in some bitter infusion. But one rem- 
edy has been much extolled ; it is this : 

No. 150. Sulphuric ether i oz. 

Spirits of turpentine ■ 1 J oz. 

Begin with forty drops, and increase gradually — taken in water. 
As ether is a solvent of cholesterine, this remedy may benefit. 

In some bad cases of pain from gall stones passing, when the 
warm bath and opiates had failed, I have succeeded with a tobacco 
injection, about twelve grains to four ounces or six ounces of water, 
or of gruel. It requires to be watched, on account of the great 
depression which tobacco, so administered, will produce in some 
constitutions ; but with brandy, ammonia, or ether, at hand, it is 
well worth while to try the remedy. In cases where spasm may 
be supposed to exist in the bile ducts, it has appeared a superior 
remedy to opium. 

If jaundice have followed after an injudicious suppression of 
any discharge, or of bleeding from piles, we must, in the latter 
case, apply leeches near to the lower bowel, so as to unload the 
surcharged great veins in the belly. 

If there is much debility, give these pills : 

No. 151. Extract of aloes fwaterv extract) ) p r oa 

Sulphate of quinine | "^ ^^''^ ^0 grs. 

Make into twenty pills ; one, two, or three, three times a day. 



Night Blindness — Nyctalopia. 

Here the sight is perfectly clear and distinct in the daytime ; but 
a total blindness takes place by night. 

It is symptomatic of disorder of the digestive organs — of the 
liver especially — and is peculiar to tropical climates. 

Repeated blisters to temples, a green silk blind over the eyes to 
be worn, and intense light avoided. Wash the eyes, several times 
a day, with cold water or an eye-wash, or collyrium : 

No. 152. Sulphate of zinc 10 grs. 

Rose water 4 oz. 



deafness— canine appetite. 317 

Deafness — (Deaf and Dumb) — 

depends on many (3auses — some capable of removal, others not so. 
Deafness sometimes depends on hardened wax in the outer ear- 
passage. This deafness is usually accompanied with noises, as of 
singing, etc., in the organ. To remove it, drop a small quantity 
of warm oil, olive or almond, into the ear, for two or three suc- 
cessive nights, and then syringe well with warm water, by means 
of a two-ounce syringe. 

Other kinds of deafness must be treated by a professional man. 
Dumbness proceeds from deafness, either existing from birth, or 
arising early in life. It rarely happens that dumbness is entailed 
by deafness so late as the tenth year. In the deafness from birth, 
sounds can never be associated with ideas ; in deafness coming on 
later in life, even if speech shall already have been acquired, it 
may gradually be lost in consequence of the want of habit to asso- 
ciate sound with speech. 

Canine Appetite — Bulimia. 

This is a craving for food beyond the natural wants of the sys- 
tem, sometimes excessive in degree. 

The quantities of food, etc., taken in some cases are almost in- 
credible. In one case, a French prisoner consumed, in one day, 
four pounds of raw cow's udder, ten pounds of raw beef, and two 
pounds of candles, with five bottles of porter. In another, the 
patient would eat any thing — the refuse of the kitchen, rejected 
matters, or corrupted meats ; he was obliged even to be driven 
from the dead room. This unfortunate and miserable man ulti- 
mately died of consumption. 

In this disease the coats of the stomach are morbidly irritable ; 
its nerves morbidly sensible, and its muscular coat especially irri- 
table, so as to move away the contents of the stomach in a very 
short time. It has been divided into the bulimia of gluttons ; into 
that of excessive appetite from exhaustion after diseases, discharges, 
etc., and into voracious appetite, followed by vomiting. 

Usually three or four large stools are passed daily ; a nauseous 
smell emanates from the body, and sometimes there are excessive 
perspirations. 

Treatment — The glutton can only be cured by a fit of illness — 



818 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

and not always then. He must employ his mind and body more, 
that he may abuse his stomach less. 

In the second kind, or that which results from exhaustion after 
disease, w^e must watch ; for no general rules can be laid down ; 
and in the third, nauseating purgatives have done good service — 
namely, castor-oil, with the oil of turpentine, and the tartar emetic 
or croton-oil liniment rubbed into the pit of the stomach. The 
patient must abstain from food to a considerable extent ; great 
■distress from hunger will be felt for a few days, which will subside. 
Dr. Crane gave portable soup, made into pills, for several weeks, 
and recovery followed. 

Opiates, or very small quantities of tobacco, will help the pa- 
tient to support better the hunger than he otherwise could do. 
Some swallow' balls made of a calcareous powder and of tobacco, 
to still the hunger and distress from fasting. 

Rumination. 

This is regurgitation of food which had passed into the stomach, 
and which is remasticated, and again swallowed, much like a cow 
chewing her cud. 

A good many instances are on record of this affection, and the 
second mastication seemed to be far from unpleasant. Anthony 
Recchi, who was a human ruminant, said of the second mastication : 
'' Indeed, it is sweeter than honey, and accompanied with a more 
delightful relish." Human rumination is an involuntary act ; yet 
the act can be hastened or suspended, for a certain time, by the 
individual. * 

It arises from insufficiently masticated and insalivated food, 
which irritates the stomach to a retrograde action, and this is com- 
bined with a distended stomach. There is probably debility with 
increased organic sensibility of the stomach. The treatment is that 
of indigestion. 

COSTIVENESS — ObSTIPATIO. 

This is said to proceed, in most cases, from a torpid state of one 
of the larger bowels (the colon). There is a deficiency of con- 
tractile power, and the fecal matters are detained in the bowel, 
giving rise to other symptoms. 

This weakness of the bowel may be caused or accompanied by 



COSTIVENESS— OBSTIPATIO. 319 

exhausting discharges, or whatever may have debilitated the gen- 
eral system. 

But \Yhen once this bowel, the colon, has become habituated to 
distension, its coats give way, and the diameter of the bowel en- 
larges to an extreme degree in some cases. 

The feculent matter may be retained in the bowel for varying 
periods ; and cases are on record where a fecal evacuation would 
take place once only in two or three weeks, yet no apparent suffer- 
ing ensue. 

Dr. Baillie published a case which continued fifteen weeks ; and 
instances of constipation for three, four, five, seven, eight and nine 
months have been recorded. One person, a young female, never 
had more than one evacuation every two months, during five years, 
and enjoyed good health. 

In these cases, the appetite has usually been wanting more or 
less, or there has been increased evacuation by the skin or the 
kidneys. 

Some of the most healthy persons are subject to costiveness, 
because an active absorption of the fluid part of the remainder of 
the food goes on in the colon, but costiveness may be caused by 
the very reverse state, of debility, in which the propelling power 
is defective. 

Causes. — Sedentary life and habits, indigestible food and im- 
proper drinks, as imperfectly prepared bread, new cheese, nuts, 
cucumbers, and others ; too much sleep, and too much bed ; by pro- 
longed suckling ; too much mental or physical exertion ; tumors 
pressing, and various lesions of structure ; rupture. 

Symptoms — vary much in different individuals, but generally the 
countenance and skin are foul and unhealthy ; the perspiration 
thick, clammy, bad smelling ; breath offensive ; tongue loaded or 
furred ; lips and gums pale ; imperfect or fanciful appetite ; diges- 
tion impeded ; the belly, which should always be closely examined, 
will be found swollen, doughy, and inelastic ; headache ; urine 
loaded ; evacuations take place, and they are slimy, very dark, or 
otherwise discolored, scanty, and offensive ; the pulse soft and 
weak, sometimes slow, at others quick. 

In the female, there may be a tendency to fainting, flabby state 
of the flesh, swelling of ankles, languor, lassitude, and pains in 
loins or belly, or much of the fecal matter may be retained, and 
yet there may be daily evacuations. The refuse matter, mixed up 



820 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

with the secretions of the bowels, lodges in the cells of the colon, 
through the center of which a passage is made ; and it would seem 
as if there was nothing retained, yet the cells of the colon may be 
full of hardened feces, only with a small central passage through 
them ; the bowel becomes more and more distended, and the evil 
goes on increasing. The stools may be liquid, or mixed with lumps, 
or slimy, of a dark-green or brownish-black hue, very offensive; 
and griping, bearing down, or a scalding sensation, accompany the 
ejection of these irritating materials from the bowels. 

Windy distension of the bowels is almost an invariable accom- 
paniment, and adds to the distress. 

Treatment. — Purgatives give immediate relief, but unfortunately 
the bowels return to their former state, and nothing short of con- 
tinual purgatives will meet the case ; it becomes, therefore, urgently 
necessary to try some other means. 

This is sometimes effectually and always most pleasantly effected 
by diet ; a change in diet will at times suffice. The bread should 
be the brown bread, with more or less of the bran in it, and this 
coarser bread is, of all agents, the most effectual. (For a fuller de- 
tail, refer to Diet and Food.) 

The accumulation in the bowels must be first got rid of. Ape- 
rients, both by mouth and injection, must be administered. We 
may give : 

No. 153. Compound decoction of aloes ) r. i -i 

T f. • r. > ^ 01 each, 1 oz. 
iniusion 01 senna j ' 

Tincture of jalap 1 drachm. 

Or a blue pill, three grains, and compound extract of colocynth, 
.three grains, in two pills, at night, and a dose of salts and senna 
next morning. If necessary, this latter may be repeated. Where 
active purgatives like these fail, a drop of croton oil in half an 
ounce of castor-oil, will succeed. 

These should not be given if there is tenderness over the part, 
with full, perhaps hard pulse ; then blisters, hot fomentations, or 
leeches, or even blood-letting from the arm. 

Clysters will often prove of great service, but should never be 
solely relied on. These only wash out a few inches of the lovfer 
bowel, unless a long pipe, say 18 inches, can be introduced, and no 
one but a medical man should attempt to do this. Some of our 
fellow-countrymen, who have been students at foreign universities, 
have seen cases where patients have had one or two daily clysters 



STRICTURE OF COLON, OR RECTUM. 321 

thrown up, yet the bowels have, after death, been found quite 
crammed with feculent matter. 



Stricture of Colon, or Rectum. 

In some cases, a stricture or mechanical impediment in the Jower 
part of the colon has existed. Here it is obvious that nothing but 
mechanical dilatation will do good. Then a rectum bougie should 
be gently introduced at certain times, but this none other than 
medical men should attempt. 

The symptoms in such a case would be an urgent desire to go to 
the water-closet ; yet, after severe straining efforts, nothing but 
wind, and a little slimy mucus, with perhaps some blood intermixed, 
are expelled. Here, active forcing purgatives will do mischief. 

Some take a dinner pill, as it is called : 

No. 154. Socotrine aloes, powdered 3 drs. 

Mastich, finely powdered 1 dr. 

Mix well together ; much depends on thorough admixture. Then 
add, of syrup of ginger, enough to make sixty pills. One or two 
of these to be taken an hour every day before dinner, or every 
other day. 

But in tolerably healthy vigorous habits, the author gives the 
following : 

No. 155. Wine of seeds of colchicum (meadow \ j^ 

saffron) J ^ 

Liquor of potash 2 drs. 

Tincture of gentian 6 drs. 

Mix. 

Dose, sixty drops, or a tea-spoonful every night and morning, 
until the motions become of a soft consistence ; then a seidlitz pow- 
der, or four grains of compound extract of colocynth, will remove 
the mass. These drops act indirectly upon the bile ducts, and so 
imitate nature's operations. But these drops should be discon- 
tinued if they seem to disagree, by causing deadly languor or sick- 
ness, or very loose stools. 

Cold-water douche to the belly, standing on cold floor, etc. In 
extreijie cases, where there is no mechanical impediment, the to- 
bacco clyster must be tried. • 

The treatment for indigestion and flatulence may be referred to ; 
the tonic infusions with carbonates of potash or of soda — diligent 
21 



322 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

frictions with the flesh-brush to belly, and when the bellj is very 
much distended, a bandage should be worn, to give tone and stim- 
ulate to contraction. 



Nervous Blindness — Gutta Serena : Amaurosis. 

Blindness — ^partial or complete, in one or both eyes. A peculiar 
gait marks the walking movements, which latter are uncertain. 

There is a characteristic stare — the pupils are fixed or oscillat- 
ing, and insensible to light. 

Treatment. — This must depend on the cause. If there is organic 
disease of the brain, we must act accordingly. 

But in many cases there is not much hope of cure ; still, where 
it depends on hysteria, or irritations in stomach and bowels, we 
may hope for restoration of sight. 

To the non-professional person, we would recommend repeated 
blistering behind the temples, and, where it can be borne, the blis- 
tered surface should be kept open by means of savin cerate, and 
small doses of calomel may be tried, until the gums begin to swell. 

Incontinence, or Immoderate Flow of Urine — Enuresis. 

This may arise from mechanical causes, or from derangements of 
the bladder. 

The urine is expelled from the bladder by the muscular coat, and 
it is retained in the bladder by a circular set of fibers which sur- 
round the neck of the bladder. Now, the muscular coat may be 
forced into undue action, or the sphincter (circular) muscle may be 
deficient in action, or palsied even. 

In either case, the urine may flow immoderately. Where the 
first state exists, there will be evidence of local irritation ; symp- 
toms of stone in the bladder, of a chronic inflammation, or of 
spasm show themselves. Here give opium in the shape of clyster 
or suppository. (See Glossary.) A grain of opium, with two or 
three grains of soap, makes a good suppository; for a clyster, 
thirty drops of tincture of opium, in three or four ounces of starch, 
will relieve the state of spasm. Besides these, warm bath, hip 
bath, cupping to the loins, aivd very gentle aperients, so that there 
need be no straining at stool. 

In the other kind, in which there is frequent making water dur^ 



DIFFICULTY IN VOIDING URINE. 323 

ing the day, and an involuntary discharge at night, we must give 
two or three drops of tincture of cantharides, with ten drops of tinc- 
ture of henbane, and increase gradually and cautiously. These 
doses are for children, who are frequently affected. For grown-up 
persons, begin with twelve drops of tincture of cantharides, every 
six hours — increased to twenty — for a few days, which will ctire. 
When signs of strangury come on, discontinue the tincture of can- 
tharides. (For signs of strangury, see next disease.) 

Children should be made to lie on their sides at night, and not 
on their backs, for, in the latter position, the urine lies in a trian- 
gular space of the bladder, which is peculiarly sensible and irritable. 
In some, doses of thirty drops of tincture of muriated iron, three 
times daily, have cured. 

The urine is perfectly retained during the day, and voided only 
at night; habit has more to do with the matter than debility of the 
circular muscle. Here we must make the children leave the bed 
about midnight for the purpose of emptying the bladder; no liquid 
should be drank in the evening, or for some time before going to 
bed. It has been necessary to threaten punishment. 

The urethra, or passage, has to be kept closed in boys or men, 
by a bit of bougie, etc., tied round it before going to bed, and the 
bladder should be emptied the last moment. 

Difficulty in VoiDiNa Urine — Strangury: Dysury. 

The term dysury comprises an arrest of the flow of urine, for a 
shorter or longer time, and a complete retention of it, with pain at 
the time, and, in some cases, the pain is severe. 

Causes. — The urine may have been retained too long, and so 
have become irritating as it passes, and a spasm arises which stops 
the flow ; or the bladder may be in an irritated or slightly inflamed 
state ; inflammation or swelling in the neighborhood of the bladder, 
as from piles, worms, and hardened feces or stools. 

Strangury means an intense degree of dysury, and may be pro- 
duced by cantharides, corrosive sublimate, fox-glove, in large doses, 
or other irritant matters. Stricture of the passage is a frequent 
cause ; and hysteria will cause it. 

Treatment. — This will obviously depend on the cause. Mechan- 
ical impediments must be removed ; hardened feces cleared away 
by an active purgative, or by clysters. 



824 AMERICAN HOUSEHOLD BOOK OF- MEDICINE. 

The urine itself must be diluted by copious draughts of barlej- 
water, in which some sweet spirits of niter have been introduced; 
or draughts of bicarbonate of potash or of soda, thirty grains of 
either; or thirty drops of liquor of potash. But warm fomenta- 
tions, and, still better, a warm bath, or hip bath, will relieve. 

The liniment of the extract of belladonna, half a drachm, in soap 
liniment, one ounce and a-half, rubbed into the perinseum. Others 
praise the tincture of muriated iron. 

Suppression of the Urine— Ischuria. 

Here no urine is voided, because its secretion is suppressed. It 
differs from retention of urine, in which the urine is retained in the 
bladder; in retention the urine is secreted in the kidney, but re- 
tained in the bladder. 

This is usually a serious and fatal disease. It occurs in persons 
advanced in life, and corpulent. Retention may lead to serious 
consequences likewise. In one case, a female, who had no oppor- 
tunity of voiding urine for some time, found she could not do so at 
last, and a rupture took place in the passage, which could never be 
healed. And if the urine is too long retained, and no operation is 
resorted to, to open the bladder, similar symptoms to those which 
terminate suppression will ensue. 

In suppression, there may or may not be any pain or weight in 
the loins, or distension in the belly. No urine may have passed 
for some time, a day or more, and, on trying by an instrument, 
none will be found in the bladder. Then nausea comes on, with 
languor and heaviness ; the pulse, at first slow, becomes excited, 
the skin hot, the features hot, etc. Then drowsiness steals on, 
generally by the third day ; the features become puffy, the ankles 
swelled. The drowsiness lapses into coma about the fourth day, 
and death, with or without convulsions, follows in two or three 
more. In some instances, the urine may be diminished daily, till 
complete suppression is developed. 

Causes. — Preexisting disease of the kidney ; cold and wet. 
Treatment. — Where there are no signs of disease of the kidney, 
blood-letting ; Dover's powder, five grains, with twenty grains of 
carbonate of potash. The warm bath is useful. Purgatives may 
be tried. 

As soon as coma sets in, there is no hope ; for this coma is one 



GRANULAR DISEASE OF THE KIDNEY. 325 

of the signs of a poisoning of the blood, by the urea it contains, 
which urea ought to be sent out of the blood and the body, through 
the kidneys. 

Granular Disease of the Kidney, or Bright's Disease. 

We have described inflammation of the kidney; in some scrof- 
ulous constitutions, it may be followed by this disease. Nearly 
forty years ago, discovery was made of the connection between 
dropsical affections and this peculiar disease, in which a yellowish, 
grain-like matter is deposited in the substance of the kidney, caus- 
ing a wasting away of certain parts of its texture, and a dropsy, 
which may be called renal. 

There is an acute and a chronic form, and its course may be 
slow or rapid. 

Symptoms are shiverings, ushering in fever ; the urine is scanty, 
almost suppressed, occasionally bloody, and passed with difficulty. 
It contains albumen, as a distinguishing sign. Albumen is famil- 
iarly knoAvn to us, in the white of the egg. It will pass, when un- 
diluted, from the fluid to the solid state, when heated to 160° of 
Fahrenheit ; when diluted, a heat of 212° becomes necessary. 

Heat then affords us the means of testing for albumen. This 
may be done in a spoon, but most conveniently in a glass tube, 
heated by means of a spirit lamp. 

As there may be mucus in the urine, we should first filter it. 
There may be so much albumen in the urine, that the whole of it 
becomes solid. Usually a whitish cloud appears, which collects 
into flakes, which subside after a time. 

Heat is not, however, a conclusive test. When recently dis- 
charged, the urine may be neutral, or even alkaline; or, it may 
become so after it has left the bladder. Now, this alkaline, or neu- 
tral urine, will not coagulate when heated, not even when it is full 
of albumen. 

We then test the urine by dropping in some nitric acid, which 
has the property of precipitating albumen in a flaky or pulpy form. 
We should test the urine, then, by first boiling it, and then drop- 
ping in nitric acid. 

To continue the symptoms — there will be pain in the loins, shoot- 
ing, down to the groin ; pain across the pit of the stomach, felt or 
increased on pressure, and attended with nausea and vomiting. 



826 AMEKICAN HOUSEHOLD BOOK OF MEDICINE. 

Anasarca or dropsy of the cellular membrane makes its appear- 
ance on the second, or even first day, sometimes. If the disease be 
not checked by active treatment, we may have some internal in- 
flammation, as in the chest. Frequently it ends in coma or stupor. 

The chronic form may follow on the acute, but more commonly 
it commences obscurely and insidiously, and the only invariable 
character is scanty, highly coagulable urine, with more or less of 
fever ; and these symptoms may prevail alone for a few days, till 
coma and convulsions supervene. Frequent making water, and 
increasing debility, obscure pains in the loins ; the urine may be 
scanty or the contrary, and its color is pale, sometimes cherry red 
or brown, often muddy, and coagulating more or less by the action 
of heat and nitric acid. This state may go on for months, or even 
a year or two, when the strength is reduced more and more ; the 
body is more or less reduced in flesh, the skin dingy or waxy pale, 
and dry, with drowsiness, sickness and retching. 

Dropsy, diarrhea, rheumatism, catarrh, diseased heart, and coma 
follow. The essential characters are, reduced density of the urine, 
with diminutions of its solids, and reduction of the coloring matter 
of the blood. The urine may or may not be coagulable, for al- 
though albumen is very generally present, it is not invariably so. 

Causes — are obscure. Intemperance, the scrofulous habit, and 
scarlet fever predispose ; the first two influence somewhat power- 
fully. Mercury, cantharides, or certain articles of diet, cheese, 
puddings, pastry, will cause albumen to appear in the urine. 

No age is exempt, but it is most frequent between the ages of 
thirty and fifty. 

The probability of recovery depends on the stage of the disease. 
Many have deemed it an incurable disease, but in its early stage, 
when the density of the urine is not much under the natural stand- 
ard, and the blood still retains its due proportion of coloring mat- 
ter, as shown by countenance and skin being of tolerably healthy 
color, recovery may be accomplished. But in advanced stages, 
when, besides the morbid deposit in the kidney, there is an atrophy 
or lessening of the structure of the kidney, there is no hope. 

Treatment. — We must look to the primary disease, and then to 
the secondary complications. 

In the acute primary disease, we must resort to blood-letting 
carried to faintness, or till the pulse is efi'ected; then cupping, or 
leeching to the loins. 



GRANULAR DISEASE OF THE KIDNEY. ' 327 

Diminislied local uneasiness, and less albumen in the urine tes- 
tify to the benefit derived from these blood-lettings. But Tve must 
not push the evacuation of blood too far, as the blood soon becomes 
impoverished in this disease, wherefore, it is advisable to examine 
the blood, and ascertain the proportion of the blood globules. 

The next point is, to induce perspiration, by five to eight grains 
of Dover's powder, thrice daily, and by a vapor or warm bath 
every evening, or oftener. James's powder, three grains may be 
substituted for the Dover's powder, and the acetate of ammonia 
is preferred by many. Laxatives are useful. 

Diuretics, such as sweet spirits of niter or acetate of potash, thirty 
drops of the former, and thirty grains of the latter, are useful when 
there is dropsy; but diuretics are condemned by some as adding 
to the irritation in the kidney. It is not proved that they do in- 
crease the irritation, for they do not increase the albumen in the 
urine, which albumen is probably a test of the irritation existing 
in the kidney. 

Mercurials must not be given, except as purgatives. 

When the disease has been brought to a stand, then we must 
have warm clothing, with avoidance of cold or damp, also of spirit- 
ous liquors, or wine or malt liquors ; give nutritious food in moder- 
ation, and use regular exercise. 

These rules should be observed, and they, with warm baths at 
certain intervals, may efi'ect further good, and prevent an attack 
or recurrence. 

For the dropsy, diaphoretics, purgatives, and diuretics ; and the 
first are best, if they will remove the dropsy ; if they do not, as 
happens not uncommonly, then diuretics. 

Give of foxglove, in powder, one or two grains, and in tincture, 
ten or fifteen drops, thrice a day ; and of bitartrate of potash, one 
or two drachms, thrice daily. The decoction of broom-tops, too, 
is useful. 

The fluid may be let out by acupuncture ; that is, puncturing 
with needles. 

Sweating medicines may be given with the diuretics. 

For the indigestion, bitters and alkalies — soda or potash. For 
the vomiting, ether, brandy and ammonia. Blisters over the stom- 
ach, opium, and hydrocyanic acid or creosote, will alleviate the 
vomiting. 

For diarrhea, opium, alternated with laxatives, or opium and 



328 AMERICAN HOUSEHOLD BOOK OP MEDICINE. 

acetate of lead, one grain of opium to three of the lead, thrice 
daily. 

To quench thirst, soda or potash water, with or without wine. 
Where internal inflammations arise, treat as in ordinary cases. 

For rheumatism, tincture of meadow saffron and opium. Coma 
usually bids defiance to all modes of treatment, unless in the early 
stage ; then blood-letting, brisk purgatives, and diuretics. 

The attending diseases of the heart are most reheved by remov- 
ing the dropsical accumulation. 

Inflammation of the Kidney, or Nephritis — Gravel and 
Stone, or Lithiasis. 

A fit of the gravel, as it is called, is attended with the following 
symptoms. But a fit of the gravel is only when a powder or con- 
crete matter is passed with the urine. It is no fit of gravel when 
the urine is ejected clear, but throws down an earthy sediment as 
it cools, which redissolves when artificially heated. 

Pain, dull, or it may be severe, in the loins, mostly on one side, 
and descending in the inside down toward the groin, numbness of 
the corresponding thigh, a drawing-up of the testicle, with pain in 
it, urine high colored, nausea and vomiting. 

The pain is increased by firm pressure when there is inflamma- 
tion, by cough or sneezing, and, in some cases, by that act of the 
breathing called expiration or breathing outward. The pain, too, 
is increased by straightening or stretching the limb on the affected 
side. The attitude preferred is that of inclining to the affected 
side, at the same time drawing up the limbs. 

The urine may at first be bloody — coagulable by heat and by 
acids ; after a time, it becomes pale, watery, not coagulable, and 
either neutral or alkaline ; frequent desire to pass it, and there is 
dysury, or difl&culty in passing it, or it may be suppressed. When 
albumen is present, there is probably some degeneration of the 
kidney. 

With these signs, fever attends ; a full, hard pulse ; tongue cov- 
ered with a white fur, constipation, anxiety of countenance, and 
depression of spirits. 

This pain must be distinguished from lumbago, and from ne- 
phralgia (a pain connected with the kidneys). 

In lumbago, the pain shoots down to the back part of the thigh, 



GRAVEL AND STONE, OR LITHIASIS. 329 

and not to the front of the body ; nor is the urine disturbed, as in 
kidney inflammation. In lumbago, the pain is on both sides ; in 
inflammation, the pain is on one side. 

The pain in colic may be confounded with this inflammatory 
pain ; but in colic, there are, at first, none of the fever symptoms 
above described ; no full, hard pulse, nor white fur on tongue. (See 
Colic.) 

The numbness of the thigh and drawing up of the testicle are 
characteristic, too ; but colic and pain is very often and may easily 
be mistaken for nephralgia, or pain caused by the passage of a 
stone from the kidney into the bladder. 

The urine is first formed from the blood in the kidney, and 
from the kidney a small, very irritable tube, the ureter, conveys it 
into the bladder — consequently, a stone formed in the kidney fol- 
lows the same course as the urine ; that is, down the ureter into 
the bladder — giving rise to spasm and pain as it passes down. 
The ureter must not be confounded with the urethra, for the latter 
is the passage to convey the fluid from the bladder outward. 

In some cases, the clinking of a small stone in the p6t-de-cham- 
bre is the only circumstance that convinces the patient of his 
sufi'ering having proceeded from stone and not from colic. Inflam- 
mation of the kidney may, like other inflammations, terminate in 
resolution (recovery), or pus (matter) may be formed ; or, in mor- 
tification, coma is a common symptom at the end of a fatal case. 

Causes. — Calculi or gravel ; acid diuretics ; long-continued and 
violent exercise of the muscles of the back, as in horse exercise ; 
hardened masses of excrement in the neighboring bowel. Gout 
may leave the external part upon which it had seized, and then at- 
tack the kidney. 

Treatment of Inflamed Kidney. — ^Blood-letting from the arm, 
by cupping, and by many leeches to the loins. 

Then give opiates, thirty or forty drops of the tincture directly 
after the blood-letting. This sometimes arrests the disease at once. 

Castor-oil, and frequent soothing clysters. 

For drinks, give barley-water, gum-water, decoctions of marsh- 
mallow, linseed tea, or even pure water, with a little niter in them. 
Warm hip baths, repeated when necessary ; warm fomentations ; 
opiate clysters, tincture of opium, thirty or forty drops to half a 
pint of starch. 

In cases of long standing, embrocations, or an issue, or a seton, 



830 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

perfect rest. The catheter to draw off the water, if necessary. 
Nephralgia, or kidney pain, may be discussed under the head of 
gravel or urinary stone. 

Gravel. 

Dull pains, or they may be acute, with a feeling of heat and of 
heaviness in the region of the loins ; there is more or less pain in 
passing the water, with pain over the bladder, and irritation at its 
neck ; itching or pain at the extremity of the yard. In some in- 
stances, the testicles are drawn upward, and the urine may be 
bloody, or there may be clots of blood in it. 

The urine, just as it is expelled, and still warm, contains a sandy 
powder, or grains of sand or small stones, of a grayish or reddish- 
brown color. It is scanty, high-colored, acid, smells strongly, and 
becomes turbid on cooling. 

With these the digestion is deranged ; there is weight at pit of 
stomach, sourness of mouth, flatulence, constipation, furred tongue, 
restlessness, and other signs of irritation. The pain is apt to be 
increased by all sudden agitation of the body, such as running, 
leaping, and riding on horseback. 

In order to understand the meaning of the terms acid urine, 
alkaline urine, our readers should know how to prepare and to use 
certain tests of acidity or alkalinity of the urine. 

For acids, litmus paper is used. It may be made by saturating 
unsized paper (free from lime) in a strong infusion of litmus (about 
one ounce to half a pint of boiling water), and drying it in a place 
entirely free from acid vapors. If not of a good blue color, dip 
it a second time. It should be kept from air and light. 

For alkalies, rose paper, made by saturating unsized paper two 
or three times in a strong infusion of red roses (about two ounces 
of the petals to a pint of water), and drying the paper quickly. 
This, too, should be kept from air and light, and in a dry situa- 
tion. 

Turmeric paper is also a test, which is changed from yellow to 
brown when the uriiie is alkaline ; blue litmus and rose paper to 
red when the urine is acid. 

Dr. B. Reid gives the following directions how to prepare test 
papers : 

"Cut a common red cabbage into small pieces, and boil it, for 
a short time, with no more water than is required to cover it; 



GRAVEL. 331 

or, infuse the cabbage in boiling water. Dip into this solution a 
nuDiber of slips of paper, four or six inches square ; let them be 
kept there till they have imbibed the color; then dry, aud keep 
them from the light, except when used. Acid reddens these, al- 
kali turns the color green. 

^'Litmus 'paper. — Boil litmus in five or six times its bulk of water; 
slips of this color, dried, are reddened by acids, but not turned to 
a green by alkalies. 

""Turmeric paper. — Pour upon a table-spoonful of turmeric, 
placed upon a common plate, three or four times its bulk of boiling 
water. Put slips of paper in it ; dry them ; they are of a fine 
yellow color, become reddish-brown by alkalies, but are not af- 
fected by acids." 

The urine in health is never alkaline. 

The gravel, or sand, may be divided into lithic gravel, or that 
composed of lithic acid and lithate of ammonia, and this is by far 
the most frequent form met with. 

Next in frequency is the phosphatic gravel, where the deposit 
consists of phosphate of lime, or the phosphate of lime and mag- 
nesia, or of both combined ; and another kind of gravel is the oxalic 
acid gravel, composed of the oxalate of lime. 

In oxalic acid gravel there is less constitutional derangement, 
in the form of fever or indigestion, before the local symptoms show 
themselves. 

If we have reason to suspect an unhealthy state of the urine, 
we should notice whether it be colorless, transparent, or turbid ; 
we should ascertain, by litmus paper, whether the urine is acid, 
alkaline, or neutral — its specific weight or gravity ; set it aside to 
see if it deposit sediment, or throw up a cream to the surface, or 
crystallize on the sides of the vessel. The urine examined should 
be just expelled ; and if any discharges exist, which are likely to 
discolor it by admixture, the water should be drawn ofi", so as to 
have it without any admixture. 

We may suppose the urates to be in excess when the urine is 
acid — when it deposits, on cooling, a red, pink, bufi'-colored, or 
white precipitate, covering the bottom of the vessel with an even 
powdery deposit, which deposit is usually copious, and is dissolved 
by heat. Uric acid urine is highly acid — deposits, on cooling, a 
red, pink, or bufi'-colored sediment, which adheres to the sides of 
the ve'ssel in hard crystalline grains, having, by microscope, the 



332 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

appearance of diamond-shaped plates or prisms; the precipitates 
are generally scanty. 

When urine is acid, alkaline, or neutral, but turbid on emission, 
and deposits a white or yellowish sediment, and is not rendered 
transparent by heat, there will be present phosphates, oxalate of 
lime, cystine, mucus or pus, or blood. Now if the phosphates are 
present, the urine is rendered transparent by acetic acid; the 
phosphates appear as powders (not crystallized) by microscope. 
The phosphates are soluble in acetic and muriatic acids, and inso- 
luble in liquor of potash. When the urine does not redden litmus 
paper, but turns it blue again when it has been reddened by a 
weak acid, or when the urine is so alkaline as to turn turmeric 
paper brown, we may conclude that a case of the phosphatic gravel, 
or tendency, is before us. 

If oxalate of lime, the urine is not affected by acetic acid or 
ammonia, but is rendered transparent by nitric acid ; and the de- 
posit, when viewed by the microscope, consists of octahedral crys- 
tals. 

If cystine is present, the urine is rendered transparent by the 
solution of ammonia, and the deposit consists of five-sided plates, 
cloaded in the centers. 

If pus or mucus be in the urine, try it by heat ; and if the urine 
be rendered transparent by heat, there is no pus ; there is a whit- 
ish sediment, not disturbed by any of these agents, and the mi- 
croscope enables us to see minute, irregular, spherical bodies, with 
grain-like surfaces. A blood sediment is red, not dissolved by 
nitric acid, heat, or acetic acid, while the deposit contains minute 
irregular bodies of yellowish color, the shape of a dime. 

There may be some dissolved constituents of the urine ; these 
are bile. To detect it, add nitric acid, and drop the fluids on a 
plate of glass, at a short distance from it ; and as they mix, exam- 
ine for the green color, which will become manifest if there is 
bile. 

Albumen in the urine is coagulated by heat, and this coagulum 
can not be redissolved by nitric acid. 

Sugar in urine gives it a sweet taste, and a high specific gravity 
of 1.025, or above. Boil the suspected urine with an equal bulk 
of liquor of potash. If sugar be present, the urine will assume a 
deep porter or beer color. 

These admixtures may be met with in the urine ; but usually the 



GRAVEL. 333 

lithic gravel, the phosphatic gravel, and the oxalic gravel are of 
greatest importance, because most frequently occurring. 

In oxalic gravel the constitution suffers less than in the other 
kinds, before the local symptoms show themselves. The parox- 
ysm, or fit of the gravel, is perhaps the first occurrence which draws 
our attention to the state of the urine, and the urine is clear when 
passed, and does not form a great deal of sediment when cooled. 

After this oxalic tendency has existed for some time, there may 
be a good deal of irritability and nervous depression, with wind in 
the stomach or bowels, and, in some cases, with certain eruptions 
of the skin, of a scaly character. 

This tendency leads to the formation of the Kthic acid deposits. 

The phosphates exist in the form of a loose and not over- 
abundant powder, and the urine is usually very abundant. But 
in other instances, the phosphates are discharged in such quanti- 
ties that the urine is very turbid, so as to look like milk. 

The general symptoms of the phosphates are severe. 

The digestion is much disturbed; the bowels are at one time 
costive, at others freely acted upon ; the pulse is small, frequent, 
and irritable. Hectic fever attacks at last. 

The phosphatic tendency is more connected with fixed or organic 
disease than is the acid gravel, as it may be called, and with it 
there often coexists a stone in the bladder, or disease of the struct- 
ure of the kidney, or disease of the neighboring parts. 

The urine is paler than usual, often smelling of ammonia as soon 
as it has passed, or very soon after passing, and it is disposed to 
become turbid (thick, not transparent), or a sort of film forms on 
the surface of the fluid, which, looked at in different lights, ex- 
hibits the colors of the rainbow. It smells sometimes like weak 
broth. 

There is a cystic gravel, in which the urine is of a greenish- 
yellow color, and of peculiar odor, and it remains muddy after 
long standing. 

But we should always examine the gravel itself; the lithic gravel 
is grayish, reddish, or brownish, not soluble in diluted muriatic 
acid, but easily soluble in liquor of potash. The sand consists of fine 
crystals, or else there are no crystals to be seen by the microscope. 
The urine is scanty, of darkish tint, is always acid to litmus paper. 

Phosphatic gravel is white or gray ; it is insoluble in liquor of 
potash, but easily dissolved in dilute muriatic or acetic acids. 



334 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

It may consist of the phosphate of lime alone, but rarely ; some- 
times it may consist of the phosphate of magnesia and ammonia. 
The urine here is pale, abundant in quantity, prone to decay, and on 
boiling it may become turbid, and deposit a white flaky precipi- 
tate, which precipitate is easily dissolved on adding nitric acid. 

Oxalic gravel is generally brown, bluish, or gray; soluble in di- 
luted nitric acid, hardly soluble in muriatic acid diluted, and it is 
insoluble in acetic acid and liquor of potash; the corresponding 
urine is pale; and if there be any oxalic acid in it, a solution of 
muriate of lime being added, there may be a white precipitate, in- 
soluble by muriatic acid. 

The cystic gravel assumes a crystalline, and, as it were, a waxy 
appearance ; it is soluble in muriatic dilute acid, not soluble in acetic 
acid, and soluble in a solution of carbonate of potash, from which the 
carbonate of ammonia precipitates it. The accompanying urine is 
of a greenish-yellow color, and of an odor as if that of the briar 
were mingled with that of decayed urine, and it remains turbid after 
resting some hours. 

Causes. — It is of importance to learn what the causes are in most 
diseases, but it is particularly so in this. 

Particular kinds of diet will give rise to gravel ; so will organic 
diseases of the urinary organs, or of digestion. It is j)romoted by 
suppressed perspiration ; and it is more frequent in infancy than 
in youth, and very frequent, if not most frequent of all, after the 
age of forty, and in old age. 

Food and drink are powerful causes, even operating singly, 
though frequently constitutional causes cooperate. 

The kind of urine in which the most frequent form of gravel is 
found, is that formed by a diet rich, nutritive, solid, and in ex- 
cess — a diet which abounds in animal principles of nitrogenous kind. 

Now, let a person live on such a diet as this, neglecting exer- 
cise, and living in indolence and luxury, the lithate of ammonia 
will soon appear ; and this lithic tendency can only be reduced by 
a moderate diet of non-nitrogenous character. 

Particular articles of diet favor the development of gravel, such 
as those which favor indigestion, and such as calcareous mineral 
waters. 

Thus, too, a fit of indigestion will cause an aggravation of the 
urinary disorder; for, if acid be secreted in undue quantity in the 
stomach, it is also secreted in excess in the urine. 



GRAVEL. 335 

Some substances which are hard of digestion would seem to fa- 
vor the formation of gravel, though they do not excite indigestion. 
Rich, heavy puddings are of this character. 

We can easily understand how highly nitrogenous food acts in 
causing acid gravel, since the excess of nitrogen derived from the 
food must be thrown out by the urine in the form of acid. Amoj;ig 
these articles of food, perhaps there is not one which will as cer- 
tainly increase the density of the urine, and increase its tendency 
to form deposits as cheese; and, accordingly, we find it is injurious 
to all those who are subject to gravel. It is very indigestible, and 
may also act in that way, besides acting through its highly nitro- 
genous character. 

Acids, acid wines, etc., are very efficient causes, and they may 
act through their own acidity, or by increasi]^g the stomach's ten- 
dency to form acid. 

Again, waters abounding in salts of lime are frequent causes, 
and the disease is common in districts in which such waters abound. 

These errors in diet chiefly conduce to the formation and de- 
posit of the lithic or uric acid gravel ; Vhile the phosphatic gravel 
tendency is fostered by indigestion, the oxalic gravel arises from 
the use of sorrel and of vegetables which contain oxalic acid. 

Certain injuries of the spine or on the loins are among the ex- 
citing causes. 

Organic diseases in the urinary organs, or in the stomach, will 
engender this disease ; so will organic diseases of the liver, and 
also of the heart. The red or purplish gravel of the lithic kind is 
thus caused, while the phosphates are formed more frequently dur- 
ing the irritation from the stone, or from fixed disease in the parts 
themselves. 

Suppressed perspiration from sudden exposure to cold, and also 
a neglect of proper exercise, will cause gravel in those who are 
predisposed, and hereditary tendency is frequent. The indolent 
often live luxuriously, and thus a diminished demand for perspira- 
tion will allow the gravel to be increased, neither the lungs nor the 
skin performing properly their functions of purifying the blood. 

Treatment. — When the digestion is impaired, the necessary 
amount of respiratory food is not dissolved ; the tissues are wasted 
by oxidation, and uric acid appears in and loads the urine. Or, 
if the food is too abundant in blood-forming material, and if there 
exists, at the same time, a deficiency of alkali, which alkali is 



336 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

necessary to promote the change in the effete matter in the blood, 
we find there will then exist a tendency to form uric acid; or, with a 
little more oxygen, oxalic acid is formed. Gelatinous food, which 
can not form blood, and is also deficient in alkali, and strong wines 
which contain no tartar, promote this tendency very considerably ; 
wherefore we should recommend light wines, which contain tartar; 
vegetables, which abound in alkali ; exercise in the open air, and 
moderation in meat or blood-forming diet. On the Rhine, where 
light wines are drank freely, uric acid complaints are not known ; 
but those who drink port and sherry are great sufferers from the 
uric acid gravel or stone, and from its frequent attending com- 
panion, gout. 

Upon these principles treatment must be based. 

There is a considerable difference in the tractability of the dif- 
ferent kinds of gravel under treatment. 

The most favorable kind is the lithic gravel, which is least fre- 
quently associated with organic and incurable disease. The phos- 
phatic is more obstinate in yielding ; it may, however, be removed 
when it has arisen from some temporary causes, such as nervous- 
ness, anxiety, etc. It may also be connected with permanently 
acting causes, such as organic disease of the liver, kidney, blad-< 
der, etc. 

Pink-colored deposits are usually thus connected, and may al- 
ways be looked on as unfavorable. 

The oxalic acid is difficult to remove, and it gives more pain 
to the sufferer than the other kinds; it is also a consequence or 
concomitant of organic disease. 

We may form a favorable opinion from the results of treatment, 
if it seem to alleviate or remove the sediments. Our objects in the 
treatment of the lithic gravel are, to increase the quantity of the 
the urine, to lessen the excess of nitrogenous principles, and to 
neutralize the acid condition of the urine, or to render it, for a 
time, even alkaline, by certain medicines, and by increasing the 
perspiration. 

The most important rule of all is to diminish the quantity of 
food taken, and to alter its quality, by diminishing the proportion 
of nitrogenous ingredients ; then we should increase the drink, al- 
ways avoiding all acid drinks ; the medicines must consist of alka- 
lies. Since the time when Stephens's remedy for gravel, which 
consisted of a soap composed of lime and soda, the alkalies have 



GRAVEL. 337 

been recognized as WgWy beneficial, botb by correcting the acid 
in the stomach and by acting on the urine itself. 

The mode of administering them is to give 20 or 30 grains, two 
or three times a day, of the bicarbonate of potash, in any proper 
vehicle ; and that vehicle may be some bitter infusion, that of the 
compound gentian, or orange-peel, or calumba, or quassia ; and bit- 
ters are valuable additions when there are signs of debility, either 
of the digestive powers or of the body itself. 

If, when there is mucb acid in the stomach, flatulence arises from 
the disengagement of the carbonic acid gas from the bicarbonate, 
then we may give tbe liquor of potash, 20 or 30 drops, in chicken 
broth, the almond mixture, milk, or the bitter infusions; but plen- 
tiful dilution must be attended to. 

We should not continue this liquor of potash long, for it is apt 
to cause irritation ; indeed, in almost all cases, it is better to give 
the bicarbonates. 

The use of alkalies has been supposed to debilitate the stomach; 
and so they would, if continued too long. But if they do act in 
this way, such an effect must arise from the abuse of them. They 
are also said to be prejudicial by changing the uric or lithic acid 
gravel (red gravel) into the phosphatic kind, or the white. Here 
we have a remedy in our own hands, which is merely to test the 
urine with test papers every day, while the alkalies are taken, and 
discontinue them as soon as tbe urine becomes alkaline or no longer 
acid. 

We should be provided with test papers, as above recommended, 
colored blue by infusion of litmus, and also with the same paper 
shghtly reddened by immersion in a weak acid. Healthy urine 
ought to turn the blue litmus paper a little red, and alkahne reme- 
dies ought not to be given in such doses, or so long, as to destroy 
this property altogether, still less to render the urine alkaline. If 
the urine turned the red paper blue, we are in danger of producing 
a deposit of the phosphates, and alkalies must be sparingly given. 

Urine, if alkaline, turns the reddened litmus paper blue ; and if 
very alkaline, turns the yellow turmeric paper brown. 

Dr. Golding Bird recommends us, from his own experience, to 
give 20 to 30 grains, three times a day, of the phosphate of soda, 
well diluted, instead of the carbonates of potash or soda. The 
phosphate of soda will not impair the digestion^ as the alkalies are 
supposed to do. 
22 



338 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Dr. Willis, however, in his work on urinary diseases, says that 
he has known the practice of taking alkalies during a long life, 
without apparent injury to the health; and Dr. Christison has 
seen them taken for twenty years without any bad effect. 

The carbonates seem to be more efficacious than magnesia or 
lime-water, which latter some practitioners much recommend. 
Magnesia is liable to one very serious objection, that of forming 
concretions in the bowels, where it has long beeri continued, or 
taken in large quantities. 

The benzoic acid prevents the formation of uric acid, says Dr. 
Golding Bird. This is the formula : 

No. 156. Carbonate of soda 90 gr. 

Benzoic acid , 40 gr. 

Phosphate of soda 3 dr. 

Boiling water 4 oz. 



When cold, add 



oz. 



Cinnamon water 7^ 

Tincture of henbane ^ oz. 

Take of this two table-spoonfuls three times a day. 

There are several mineral waters very serviceable in gravel. 
Those of Vichy, near the Pyrenees ; of Val and Carlsbad ; and of 
these the writer especially recommends the first. In one case, the 
effects were both immediate and striking ; for the urine became 
clear after a very few doses, while the small proportion of iron 
which enters into their composition acted decidedly as a strength- 
ener of the digestion. These waters (see p. 125) are as nearly 
tasteless as possible, and they may be taken with any wine of good 
body, and not acescent. 

Another recommendation of these alkaline waters is, that they 
foster no tendency to the formation of phosphatic deposits, instead 
of the lithic acid. 

Exercise, both regular and active, has been insisted on by all 
practically-informed men. It is true that during exercise the 
quantity of the urine is diminished; but this is counterbalanced 
by an increase of the perspiration, while exercise tends to lessen 
the quantity of the discharge from the bowels, which is derived 
from the food, and this is effected by its occasioning a greater de- 
mand for nutriment, causing a greater consumption of the food, 
and, consequently, leaving less residue to pass through the bowels. 

If much excitement or irritability in the urinary organs and pas- 



GRAVEL. 339 

sages attend, active exercise Trill increase the pain, so that gentle 
exercise can then alone be borne, and, in some cases, even absolute 
rest becomes necessary. 

Here practical tact, a correct appreciation of the existing state, 
and the knowledge derived from experience, are all called into 
requisition. 

Where indigestion accompanies the gravel, much difficulty may 
exist as to the diet to be chosen. A vegetable diet may, in such 
cases, be called for, to lessen the gravel ; but the stomach may be 
so enfeebled as to require a different diet, or there may exist an 
irritability of the stomach, or an imperfect conversion of the food 
into chyme. 

The irritability is best combated by leeches, or stimulant em- 
brocations, by giving bismuth, hydrocyanic acid, etc. ; the other 
state demands bitters, iron, etc. 

The carbonates may continue to be given, and animal food may 
be allowed in small quantity. 

The blue pill, two or three times a week, is useful, and some 
aperient next morning. 

Avoid checking the perspiration, and also exposure to cold, 
wherefore warm clothing is desirable ; and if any check should 
happen, order warm baths immediately, to restore the functions of 
the skin. 

Some have an idea that it is proper to force out the gravel by 
medicines which stimulate the kidneys, such as turpentine, can- 
tharides, etc. I have never been obliged to order these reme- 
dies. 

In the phosphatic gravel, our treatment must differ considerably. 
The urine is neither defective as to quantity, nor is there any 
excess of the nitrogenous ingredient in it, while the whole powers 
of the system are enfeebled by some long-existing causes, or by 
some chronic disease, which has been long exhausting the vital 
powers. 

The diet must comprise nutritious and digestible food, includ- 
ing wine, in many cases, according to the general state. To di- 
minish the deposit in the urine, acids are to be used — not that they 
act by neutralizing the alkalinity of the urine, so much as by im- 
proving the digestion. It is now a received opinion that acids 
will neutralize the alkaline urine in some cases, and that alkalies 
will increase the tendency to deposit j still, it has been found that 



840 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

alkalies, in the form of the bicarbonates, much diluted, will cor- 
rect the phosphatic tendency. 

The mineral water of Yichj (see page 125), which has just been 
recommended in the lithic gravel cases, will act beneficially in 
phosphatic cases, removing deposits and relieving the suffering. 
The chalybeate ingredient is here probably useful. 

Laxatives are to be given, and such as tend to increase the 
quantity of the urine are to be preferred — the neutral salts, as 
cream of tartar, etc. 

The secretions must be regulated by blue pill, or by an occa- 
sional dose of calomel. 

For pain, we must give opium — from twenty to thirty drops 
of tincture of opium, when pain is severe, or a grain of opium at 
night, or five to ten grains of Dover's powder. 

The preferable acids are the nitric or muriatic (hydrochloric), 
or both combined, and they may be given in the decoctions of 
pareira brava, or uva ursa (whortleberry.) 

Decoction of Pareira Brava. 

No. 157. Take of sliced pareira 10 drs. 

" Distilled water 1 J pt. 

Boil down to a pint. 

The whortleberry decoction is made by putting one ounce of 
the whortleberry leaves into a pint and a half of water, and boil- 
ing down to a pint. 

No. 158. Of either of these decoctions ........ 1 J or 2 oz. 

Dilute nitric acid ) n -ur. iaj 

TT J 11 • -J ^ 01 each 5 to 10 drops 

Hydrochloric acid j ^ 

Mix. 

Take three times a day. 

Oxalic gravel demands treatment similar to that recommended 
for lithic gravel, only the diet does not require to be so abstemi- 
ous, or to consist of vegetables, as in that for lithic acids. 

Moderate living, the alkaline carbonates of potash or soda, 
properly regulated exercise, warm baths, and warm clothing, are 
what is wanted. Sorrel, wood sorrel, and all articles containing 
the oxalic acid, must be strictly avoided. It is also better to rely 
on the carbonate of potash than that of soda, as the former causes 
salts to form, more soluble than those formed by soda. The 
bicarbonate of soda may sometimes combine with the lithic acid, 
and form lithate of soda, which is an insoluble salt ; whereas, if 



STONE, OR URINARY CALCULUS. 341 

the bicarbonate of potash combines with the lithic acid, the result- 
ing Hthate of soda is a soluble salt, and so passes off in the urine 
without any danger. 

Alkalies should be given an hour before food is taken, so as not 
to interfere with digestion. 

Warm baths must never be neglected ; they are powerful meafis; 
for they act on the nerves as a stimulant or a sedative, and on the 
blood in two ways — one by removing substances from it, the other 
by enabling remedies to be absorbed into it. 

The Teplitz alkahne bath may do good by the alkali being ab- 
sorbed. That the action of these baths may be made either stimu- 
lant or sedative is evident, and cold may be managed to act in a 
similar way.|| 

To remove substances from the blood, the vapor bath is most 
efficient ; and the two baths, vapor and warm-water bath, should 
be used in succession, and both before food is taken, as the system 
will then be in a fitter state for absorption. 

The vapor bath first, to remove water and acid substances from 
the blood; then, immediately after, an alkaline water bath, by 
which alkaline water may be taken into the blood. 

The diet, in lithic gravel, should exclude as much nitrogenous 
food as possible ; only a moderate quantity of meat and a small 
proportion of bread are to be allowed. Flour has too much starch 
to allow of living on bread. The object is to repair the tissues, 
and yet introduce as little of nitrogenous matter into the blood as 
possible. In vegetables, sugar and starch abound, and nitroge- 
nous and oleaginous material exist in small quantity. Greens and 
peas are inadmissible ; so are apples and pears. 

There is no objection to fat, but an excess of butter must be 
avoided. 

Gelatine in soups and jellies maybe taken, in lieu, partially, of 
meat; for the albuminous tissues can not be formed from it, and 
the strength would fail ; wherefore some meat is necessary. 

For drink, distilled water, oxygenate water, etc. 

Stone, or Urinary Calculus. 

Sand or gravel may be converted into stone, or a portion of it 
may be cemented into stone, while the remainder may be- passed 
as gravel. 



342 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

This "binding together of the particles of gravel is very impor- 
tant ; for if there be no animal matter in the kidney to act as the 
cement, no stone will be formed, or very rarely, since stone is 
seldom or never formed from a nucleus, created in the bladder, but 
in the kidney. 

Whence comes this cement, or how is it formed ? The mucous 
membrane of certain parts of the kidney secretes, or forms, in 
health, a fluid, diluent and watery ; but when the parts are in- 
flamed, or when the blood from which this mucous fluid comes is 
too rich, too fibrinous, this usually diluent fluid becomes thick- 
ened, or inspissated into a kind of glue or cement. 

Thus the first class of causes of urinary stone is, either an in- 
flammatory state of the kidney, or too animalized ^state of the 
blood ; hence the advantage from plentiful dilution, from exercise, 
from a diet not too luxurious, and from healthy digestion, which 
precludes the formation of acid. 

The second class of causes are those producing a sudden change 
in the state of activity of the kidneys ; suppressed perspiration 
causes increased vicarious action in the kidneys, and the excre- 
mentitious matter, which the skin ought to have carried ofi*, is 
transferred to the kidneys, and solid particles in the urine are de- 
posited. This transfer of action excites also inflammation of the 
kidney, and thus the plastic lymph is formed. These facts give 
us some insight into the way in which cold, bleak, damp situations 
seem to favor the well-known occurrence of stone in such dis- 
tricts. 

A third class of causes is erroneous diet. "When the fluids in 
the alimentary canal are acid, the urine is acid ; and by giving 
alkalies, it becomes alkaline. If in. the stomach of a person living 
chiefly on animial food too much acid be generated, uric acid pre- 
dominates in the urine ; but when acid is produced in the stomach 
under poor diet, oxalate of lime is often formed in the kidney. 

We have thus examined the causes leading to the formation of 
urinary stones, because patients who pass gravel may avoid the 
graver results from calculi, by avoiding the causes which conduce 
to the formation of the animal cement or glue above described, 
and they may pass great quantities of gravel, for many years, 
without the formation of a single calculus. 

Symptoms — are those of gravel, with those arising from the im- 
paction or passage of the stone from the kidney, down the narrow 



STONE, OR URINARY CALCULUS. 343 

and irritable passage into the bladder, called tbe ureter. A stone 
in the kidney is attended with pain or uneasiness in the loins, 
when it begins to excite pain, though it may lie in the kidney for 
an uncertain time, without any manifestation of its presence. 

The pain from a stone in the kidney is usually attended with a 
pain at the neck of the bladder, low down in the body ; that ft^om 
a stone in the bladder is seated more at the end of the yard. The 
renal calculus may cause a wasting away of the kidney, or an in- 
fiammation in the parts. Of wasting away, there is no marked 
symptom, but the inflammation shows itself by the ordinary signs of 
inflammation. Hectic fever sets in at last, if relief be not obtained. 

When the stone is passing downward, there are pains like those 
of colic, only fixed in a region corresponding with the course of 
the ureter ; and nausea, anxiety, constant desire to pass a scanty 
and sometimes bloody urine, with great pain, will also attend. 

Suddenly these sufi"erings cease, and then it is probable that 
the stone has passed into the bladder. There it may remain with- 
out uneasiness, until it has increased to a large size ; but its char- 
acteristic effects are, frequent desire to make water, a sense of 
weight and uneasiness in the bladder and at its neck ; the pain 
is increased by exercise, exertion, or jolts ; gravel escapes in aug- 
mented quantities, and there will be itching and pain at the glans 
penis, and this is endeavored to be alleviated by stretching and 
pulling the foreskin, which becomes elongated. The constitution 
sympathizes, and there are impaired digestion, feverishness, dis- 
turbed sleep, debility, emaciation, and anxiety, the urine becom- 
ing mixed with mucus and streaks of blood. 

The presence of the calculus or stone is made evident by sound- 
ing. If the stone gets into the urethra, and there sticks from its 
size, it causes pain at the part, and an inability to pass any urine. 
Inflammation of the bladder at length takes place. 

These kinds of calculi vary in size and form. Those which are 
in the kidney are small— often no larger than a pin's head, and 
seldom larger than a pea — but when they get into the outlet of the 
kidney, they may grow much larger, even attaining the size of a 
tennis-ball, and weighing two or three ounces. Stones in the blad- 
der may be very large indeed ; and some weighing twelve ounces 
have been extracted from the bladder ; and one has been found in 
the bladder, Dr. Ckristison tells us, which weighed forty -four 
ounces. 



344 AMERICAN HOUSEHOLD BOOK OF "MEDICINE. 

They diiFer variously, also, both as to form and surface ; and the 
rougher, the more angular the surface, the greater the pain. They 
may vary in composition ; some are composed of alternate layers 
of lithlc acid and other components. The nucleus is usually small, 
and mostly consists of lithate of ammonia or of oxalate of lime ; 
but a nucleus may be formed of a clot of blood, or in the bladder, 
of a broken instrument, a portion of a bodkin, or bone^ a tooth, at 
pebble, and such like. 

Treatment of Stone.— The great object is to try to prevent the 
binding of the particles of gravel into a stone, which is to be done 
hj avoiding the causes which have been shown above ; and the 
treatment for gravel is also the treatment for stone, so we need 
not repeat. But, in addition, we have to deal with the stone in its 
passage down the ureter, or when it is there arrested. 

To calm the intense pain, opium, twenty or thirty drops of the 
tincture, repeated as often as circumstances seem to require. 

To relax the spasm or the contraction of the passage, warm baths 
must be tidied ; also anodyne injections, such as twenty or thirty 
or more drops of laudanum, in some water, at near blood heat. A 
strong purgative will promote the expulsion of the stone some- 
times. 

Many attempts have been made to dissolve the stone in the blad- 
der by injections into it ; but it was always supposed that the so- 
lutions for injecting required to be so strong, for any solvent effect 
to be produced on the calculus, that it was feared the coats of the 
bladder would suffer. It has lately been found that such strong 
injections are not needed, and that it was only necessary that the 
water or fluid to be injected should be often changed, or else sup- 
plied in a continuous stream. 

Sir Benjamin Brodie has proved that a solution of two drops 
and a half of nitric acid, in every ounce of water, may be injected 
with impunity, even into a tender, irritable bladder ; and he effected 
a cure, in one instance, by using an injection of this strength, for 
fifteen or thirty minutes, every two, three, or four days. 

To inject any fluid into the bladder, a double catheter is neces- 
sary. Diluted solutions of the alkaline carbonates, or the Yichy 
waters, may, with safety, be thrown into the bladder in the lithio 
gravel cases. 

Galvanism has been proposed, to break down the stones intQ 
gravel, which is ejected very easily. 



CANCEE, OR SCniRHUS. 345 



Cancer, or Scirrhus. 



Many names have been given to growths of this nature — scirrhus, * 
stone cancer, soft cancer, colloid or gum cancer ; mammary sar- 
coma, containing a substance like boiled udder ; lardaceous sar- 
coma, containing white matter, varying in consistence from ""that 
of softish cartilage to that of pork fat. 

Scirrhus is remarkable for its hardness ; it creaks when divided 
by a sharp knife, when the surfaces exposed by the knife show a 
glistening appearance, like that of satin, and a white, or gray, or 
bluish-white color. Intersecting bands, having a fibrous aspect, 
run across this grayish substance. By strong pressure, a thin 
liquid may be made to ooze from a slice of the tumor. 

Another kind of cancer is called the encephaloid or brain-like. 
Here we see a soft, white, opaque, pulpy substance, which resem- 
bles the human brain. This pulp is traversed and circumscribed 
by fibrous dividing lines, which are sometimes extremely thin and 
delicate. 

The third kind is the colloid, or gelatiniform, or areolar cancer ; 
and here we see small portions of a greenish-yellow, transparent 
gum, or jelly, arranged in regular cells. 

All these kinds are prone to multiply in various other parts, 
when they once occur in one part ; they are attended with severe, 
lancinating or shooting pain ; they are not to be controlled by any 
known remedy ; they tend to augment in bulk, more or less rapidly, 
eating away contiguous parts ; they break out when near the sur- 
face into a foul ulceration, producing ghastly disfigurement, and 
ultimately destroying life. 

This dreadful foe attacks almost every organ or texture of the 
body. 

The parts most liable to cancer are those which are either ex- 
posed by their situation to slight accidental injuries, or by their 
function to variations in the supply of blood. To the former be- 
long the integuments, the gullet, and the organs of locomotion; 
to the latter, the womb, stomach, liver, and testicle. The female 
breast belongs to both heads, and this disease frequently attacks it. 

The morbid deposit is met with in those parts of organs which 
contain secreting organs, as in the mouth and neck of the womb, 
and the pylorus (the outlet from the stomach into the bowels). 

The signs of the cancerous tendency, when fully developed, are 



346 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

sufficiently characteristic ; tlie complexion has a pale, lemon tinge ; 
the eye is lusterless ; the countenance sad ; emaciation, disordered 
digestion, and languor of mind and body attend. 

It is not always easy to tell the cancerous formation from some 
non-malignant disease; and some tumors have been hastily ad- 
judged to be cancerous which were not so, adding much needless 
anxiety to the patient's mind. 

If the part attacked is insulated, we must form our conclusion 
from the character of the pain, which is peculiar, of a darting kind, 
and subject to nightly increase, from the form of the ulcer, from 
the intractability of the disease, and, lastly, from the enlargement 
of the adjoining veins. If, with these, the constitutional signs are 
also present, we are more able to form a conclusion ; for, though 
none of these signs cfan be relied on singly, yet on all united we 
may place some confidence. 

Even in the dead subject, careful dissection is sometimes requi- 
site to make manifest the nature of the disease. 

The mode in which cancer originates is uncertain ; the mode in 
which it spreads and multiplies is better understood. Sometimes 
several separate and distant organs may be attacked by cancer at 
the same time ; at others, it begins in one spot, say the breast, with 
a small tumor, while the general health is not affected. This tu- 
mor enlarges and softens ; the glands in the armpits swell, become 
hard and painful; an open ulcer is at length formed, and soon 
deposits take place in some of the internal organs, forming sec- 
ondary tumors or deposits, and the latter are said, by many, to be 
caused by the former. 

If this be true, one rule becomes evident, namely, to remove 
the primary tumor as soon as possible ; but it is very uncertain 
whether early operations should be advised, or how many never 
suffer from second attacks, for cancer is a blood disease. 

Some special state of the natural solid tissues forms a most es- 
sential element of cancerous disease, and the tumor is a mere acci- 
dent, and a sort of local agent in evolving the malady ; and, lastly, 
there is a peculiar constitutional state, the nature of which can 
not, at the present day, be even divined, which is the very fountain 
and origin of the disease. 

In the first period the blood and solids are specially modified. 
Injury perhaps occurs, and an exudation, containing an intrinsic 
power of vegetation follows ; the vegetating faculty of the exuda- 



CANCER, OR SCIRRHUS. M7 

tion reacts on tlie system, by constantly draining it of its nutrient 
materials ; the progeny feeds on the parent organism. 

In the second period, the exudation encroaches and causes ulcer- 
ation ; discharges occur and drain the system. 

Third period. This is the last period of exhaustion. 

We shall have occasion to mention cancer of the womb^ etc., 
elsewhere ; so, in this place we will allude to the general treatment, 
which is, indeed, the only treatment that can prove efficacious. 

Treatment. — The best preventives comprise every thing that 
tends to keep the body in health. 

The curative contains a long list of remedies. Some of the 
most noted we will mention. 

Hemlock. — Much difference of opinion exists as to the curative 
efficacy of this plant; but cases are on record giving an impres- 
sion that the disease has been arrested in its advance by hemlock, 
long continued, and the quantity increased unto even poisonous 
doses. 

Dr. A. Bayle gives three hundred and forty-one cases of cancer 
thus treated, whereof forty-six were cured, twenty-eight benefited, 
while in two hundred and sixty-seven no benefit accrued. 

Dr. Walshe thinks that the hemlock is only useful by assuaging 
irritability and pain; he gave ten grains of the extract three times 
a day. 

Belladonna, or Deadly Nightshade. — One case was cured by in- 
fusion of belladonna, and a plaster of it was worn ; a woman of 
fifty-one w^as the patient. 

Aconite (monks-hood), henbane, laurel, stramonium, mezereon 
have all failed. Foxglove also failed. 

Sedum Acre (wall pepper) has seemed to quiet irritability ; two 
.to fifteen grains, daily. 

Antacids — Ammonia. — Martinet and Barbette, in 1781, speak 
enthusiastically of ammonia, both externally and internally. Give 
four or five grains, in water, daily, and apply this lotion : 

No. 159. Strong liquor of ammonia ^ oz. 

Water 1 pint. 

Place linen folds, wetted with this, on the part twice daily. 
Much benefit was derived during the most advanced ulceration. 

Tonics — Iron. — Mr. Carmichael extolled iron ; used it externally 
and gave it internally. 

Monsieur Duponget gave the biphosphate of iron in three cases ; 



f 

348 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

the fetid discharge was corrected, pain removed, appetite and sleep 
restored. 

Dr. A. Thomson gives the iodide of iron, the syrup of the iodide ; 
three grains of the iodide. 

Gold and copper have been tried, but without benefit ; so has 
the chloride of barium. 

Mercury is considered highly pernicious by most practitioners. 

Iodide of potassium in some mucilaginous liquid, about one hour 
and a half after meals, may be tried, if there is no irritability of 
the mucous membrane of the alimentary canal. 

Arsenic.' — A Swede, in 1778, cured thirty cases, in fifty years' 
practice, by arsenic. Mr. Hill thinks it will retard the complaint, 
and prevent the ulcerative stage. It may be given in conjunc- 
tion with narcotics and alkalies, or otherwise. But we can com- 
bine two powerful alteratives in the iodide of arsenic; it must be 
given in doses, beginning with one-sixteenth of a grain twice daily, 
two hours after eating, increased to one-twelfth of a grain; this 
may be borne for months. Its action must be watched, and un- 
usual perspirations, with dry gullet, give warning when to stop ; so 
does headache. The pain and tumor may decrease in violence 
under this remedy, the general health improves, and the tumor di- 
minishes, or the enlargement is at least suspended. Dr. Walshe 
tried this, in some cases, where the constitution had begun to suffer. 

This seems the only remedy that is worth trying; but Dr. A. 
Thomson always put his patients on a milk and vegetable diet, ex- 
cluding meat, which latter caused more stimulus than a vegetable 
diet would; and the stimulus of a meat diet might possibly be in- 
compatible with the action of the iodide of arsenic. Dr. A. Thomson 
published three cases of what he considered cure, and in which 
there had been no recurrence for years. 

As to external applications, leeches, occasionally applied, seem 
to relieve local fullness, but much leeching will only break up the 
constitution. 

Iodide of Lead Ointment. — One drachm of iodide of lead to one 
ounce of lard. Smear the part very gently with this, twice a day. 

Pressure, whenever it can be applied, and the tumor is not of 
excessive bulk, should be resorted to early, and Dr. Arnott has 
invented an apparatus for the purpose. This pressure relieved the 
pain in a very marked manner, so long as it is kept applied. Dr. 
Walshe says its effects are, removal of existing adhesions, disap- 



BRONCHOCELE, OR SWELLED NECK. 349 

pearance of swelling in the communicating lymphatic glands, ces- 
sation of pain, and gradual reduction of bulky masses to small, 
rounded nodules, or hard flat patches (which appear to be, both 
locally and generally, perfectly innocuous), and in the most favor- 
able cases, a total removal of the morbid production. But the 
pressure must be tried as early as possible. To avert bleeding 
from the part, the slack air-cushion must be used. 

To open cancer, various applications are made — hemlock poul- 
tices, yeast poultices, also poultices of stramonium, or of bruised 
carrots. Various caustics have been tried, but with little good 
result. Dr. Walshe's summary of deductions is, that undoubted 
cancerous tumors, both before and after ulceration has set in, 
have been cured or rendered innocuous. 

The notion that cancer is always incurable by remedies is not 
warranted. Cancerous growths may, at an early period, be re- 
moved altogether. Treatment, even when it fails to cure, may alle- 
viate much or produce, a suspension of the disease. Well-directed 
compression aids the other remedies. 

Dr. Arnott has applied intense cold to ca.ncer with happy effect. 
The tumors seem to become blanched and cold when thus treated. 

All modes of treatment fail in some cases, or even exasperate ; 
but we can not tell beforehand which cases will prove incurable. 
The brain-like and gummy cancer are less within the influence of 
remedies than is scirrhus. 

Cancerous affections may last from a few weeks to many years ; 
even ulcerated cancer may exercise no obvious influence in short- 
ening life, and hardly cause any more inconvenience than a per- 
petual issue would do. 

Bronchocele, or Swelled Neck. 

This is a swelling in front of the neck, called also Wen, andj 
when large, very much disfiguring the person. The swelling is, 
at first, firm and elastic, then soft and flabby. It grows slowly at 
first, but sometimes increases very rapidly, extending in all direc- 
tions — upward, downward, and sideways; it may even overhang 
the chest, and, by its press.ure, cause much inconvenience. 

Causes. — The female sex, hereditary tendency, and puberty are 
predisposing causes. The exciting causes are unknown. It is 



350 AMERICAN HOUSEHOLD. BOOK OF MEDICINE. 

endemic in certain places and countries. When combined with 
imbecility and idiocy, it is the cretinism of Switzerland. 

Treatment. — If there is heat of skin, or the patient is full bodied, 
lower at first a little ; apply leeches near the part. 

Then paint once daily with tincture of iodide, or rub in some 
iodide ointment. 

At the same time, give about two grains of the iodide of potash, 
three times a day. 

Setons and all operations must be done by the surgeon. 

Headache. 

Headaches may be divided into dyspeptic or sick -headache ; 2d, 
nervous ; 3d, from fullness of the vessels in the head ; 4th, rheu- 
matic ; 5th, gouty ; 6th, from disease of the brain. The signs of 
the first are chilliness, lassitude, coldness of feet ; face flushed, 
swelled, and forehead hot; a dull and heavy pain in forehead or 
temples; veins swollen; no appetite, sickness; pulse quickened, 
often full ; brown fur on tongue ; acrid sensation at back of the 
throat, particularly after eructations ; mouth clammy, saliva thick, 
breath offensive ; skin dry and parched ; urine limpid and abun- 
dant; palms of hands hot; intellect impaired for the time. The 
pain will shift to over the eyebrow, and this pain is peculiar to 
stomach and bowel irritation ; noise and light aggravate the pain, 
and the pupil of the eye is contracted. Retching, vomiting, and 
straining succeed, at first increasing the pain. Next morning the 
pain may be gone, but it may recur from some atmospherical cause. 

Sometimes the liver ducts become implicated, and much bile is 
discharged. 

Causes. — Every thing that deranges the stomach, improper food, 
constipation. The second, or nervous headache — the signs are 
here those of the first kind, only in the nervous the pain precedes 
the signs of stomach disorder, and the pain is acute and excru- 
ciating, not dull and heavy ; pulse small and frequent. This often 
comes on after mental excitement or fatigue. It is more frequent 
in females, and is often connected with monthly suppression. It 
may be severe during the day, and go off toward evening ; but it 
generally recurs every evening, owing to the periodical augmenta- 
tion of the energy of the brain occurring every evening. The 
headache of hysteria is preceded by spasmodic pains in the belly ; 



HEADACHE FROM FULLNESS. 351 

then confined pain in the head and about it, and it is confined to 
a space that can be covered by a nail ; wherefore this headache is 
called clavus. Here the attack is sudden, flatus is expelled, and 
antispasmodics relieve. This nervous kind generally comes on 
after excesses or fatigues ; constipation and irritation in the bowels 
are causes. This headache may become habitual, or impair tl\e in- 
tellect or sight. 

Treatment of these two kinds. — An emetic in the dyspeptic, if 
there is no fullness in the head-vessels ; Eau de Cologne, one 
drachm in camphor mixture, one or two ounces ; or the carbonate 
of potash, thirty grains, with spirits of sulphuric ether, thirty drops, 
in nutmeg water and distilled water, an ounce of each. A colo- 
cynth and blue pill at night ; next day, effervescing draughts with 
tincture of gentian, one drachm in each. 

Eau de Cologne externally, mustard baths to feet ; opiates are 
pernicious. 

After the bowels are open, give half-grain doses of extract of 
aconite, every three or four hours. 

Headache from Fullness. 

The arteries may pour too much blood into the brain, or the 
veins may convey it too sluggishly away, whence stagnation arises. 
In the arterial, the face is flushed, tumid, and pulse full; in the 
venous, there is paleness of countenance, a spare habit of body, 
and small, feeble pulse. The pain is dull, deep-seated, going down 
the back ; eyelids heavy and depressed ; stiffness at back of the 
neck, vivacity gone, mind cloudy; a feeling as if a cord were 
bound round the head, also similar feeling at pit of the stomach ; 
enlarged pupils, dizziness, and a sense of fullness, confusion of 
thought and intellect. 

Causes. — Excessive fullness of vessels, great corpulency, a stoop- 
ing position, and sedentary life ; suppression of accustomed dis- 
charges, cold, hair worn too long, mental anxiety, atmospheric 
changes. Headaches are dangerous when they are attended with 
signs of some disease in the brain, such as noises in the ears, much 
giddiness, temporary loss or obscurity of sight, difficult or slow 
utterance, numbness. Violent, constant, and obstinate headaches 
, are more alarming than are those which arise out of some tempo- 
rary and removable cause. 



852 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Treatment— Where there are signs of fullness, blood-letting, 
leeching, and very moderate or low diet, purges, cold to head, res- 
toration of suppressed evacuations ; but if there is more weakness 
than fullness, then purges are preferable, which take away the 
watery parts of the blood, and not the red particles ; the quantity 
of blood circulating will thus be materially lessened. 

The rheumatic headache is relieved by pressure; it is an ach- 
ing, heavy pain ; it may continue for several days, and is always 
worse at night, often coming on at the same hour; the arteries 
of head and temples do not throb, nor is the head hot, but rather 
cold. The cause of this is cold draughts of air. 

Here warm baths are of great service, in most cases ; give Do- 
ver's powder, five grains at night; purges, consisting of pills of 
quinine, one grain, and acetous extract of colchicum, half a grain, 
or one grain twice a day. 

Gouty Headache. 

Here there is the accompaniment of gouty symptoms. The 
treatment is similar to that for the last kind, only the carbonate 
of potash or soda must be given. (See Gout.) 

Headache from Affection op Brain. 

The head is more disturbed and pain more constant than in the 
other kinds. The treatment must depend on the state of the brain 
itself. 

TOOTHACHE. 

If the tooth is rotten, extraction is the best remedy ; where this 
can not be done, there are various applications — dropping prussic 
acid into the tooth, or nitric acid, or this : 

No. 160. Alum reduced to powder 2 drs. 

Spirits of nitric ether 7 drs. 

This has been said to cure the worst cases. 
Another is this : 

No. 161. Creosote 30 drops. 

Tincture of opium 60 drops. 

Mastic 2 drs. 

Make a paste. 



FACEACHE— NEURALGIA— TIC DOULOUREUX. 353 

Another excellent remedy, saidto be infallible : 

No. 162. Powdered capsicum 2 to 3 drs. 

Cyanuret of potash 10 grs. 

Molasses i oz. 

Mix. 

The Gregorian remedy consisted of Curry powder made into* a 
paste with brandy. 

For tooth-powder, prepared chalk with cinnamon powder is the 
best. Some oil of roses may be added. The chalk neutralizes 
the acidity of the mouth. 

There is a form of faceache, or neuralgia, in which the pain 
seems to be fixed in the teeth, and many sound teeth have been 
in vain extracted. The treatment should be constitutional, or 
else all the teeth may be taken out, and no good result. 



Faceache — Neuralgia — Tic Douloureux. 

To the physiologist it would not appear extraordinary if spas- 
modic attacks of pain, in various parts of the human frame, were 
much more frequently met with than they are ; for it is so constituted 
as to render it peculiarly sensible to the electrical changes in the 
atmosphere. The pains of chronic rheumatism are frequently 
exasperated during the prevalence of certain winds — the east, 
*' neither fit for man nor beast," and the north-east especially. 
Even in bed in the morning, before rising, many persons have 
been able to tell that the wind has changed to east, from increase 
or accession of pain. Neither the mere coldness nor humidity 
would be likely to produce such an eifect on a person in bed, but 
all-pervading electricity might. And, again, some persons have 
been relieved of their pains by seating them on a seat resting on 
glass, thereby insulating them, and preventing the passage of the 
electric fluid through them ; and others, by the employment of 
Pulvermacher's hydro-electric voltaic chain, and of electricity. 

The student in organic chemistry finds some clue to the ra- 
tionale of these facts, when he reads about the secreted fluids of 
the body ; for while the blood, saliva, the intestinal secretion, the 
bile, and milk, are alkaline, and the pancreatic juice either alka- 
line or neutral, the juice of the muscles, the gastric juice and the 
urine of the carnivorous and omnivorous animals are acid. The 
acidity of the juice of flesh depends on the phosphate of potash, 
23 



354 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

whicli is an acid salt ; yet it is formed in close proximity to the 
alkaline phosphate of soda, which is in the blood, the blood and 
juice of flesh being separated only by very fine membranes. An 
alkaline state of the blood is indispensable to its functions ; for 
life could not coexist if the blood were acid, therefore every acid 
that enters the blood must be neutralized. Yet the blood is in 
close proximity to an acid liquid — the juice of the flesh — and is 
communicating with it, with the gastric juice, and with urine, 
while it is frequently receiving uric acid and other acids. 

We thus see that a galvanic circle is formed, ever acting in the 
body, by the existence, in all its parts, of an alkaline liquid — the 
blood — and an acid liquid, the juice of the flesh, separated by a 
very thin membrane, and in contact with muscles and nerves ; and 
thus electric currents may take place in the body, causing the con- 
traction of muscles, and the occurrence of pain, when the muscles 
contract from disordered function. The animal body may be re- 
garded as a galvanic engine for the production of mechanical force. 

Neuralgia is a very agonizing pain in the face, coming on at 
uncertain intervals, and darting along the course of one of the 
nerves of the face. If the eye is afi'ected, tears will -flow ; if the 
mouth or jaw, the saliva is increased. It continues for an uncer- 
tain time, and disappears as suddenly as it came on. When the 
pain attacks the eyebrow, it often comes on periodically. This 
form has been called " brow ague." The general health is unaf- 
fected, and life continues often to an old age. 
fc Causes. — These may depend on functional derangement, or on 
organic disease. Nine diiferent causes have been assigned by one 
writer on this subject, viz.: A neuralgic habit; 2d, dyspepsia; 3d, 
disease of liver and other organs; 4th, too little blood in the 
system ; 5th, disease of the spine ; 6th, disease of the womb ; 7th, 
disease of the brain ; 8th, local mechanical causes ; 9th, malaria 
and recession of eruptions, and other causes. 

Treatment. — This must be arranged according to the causes. 
Carbonate of iron is the most successful remedy, and large doses 
are given by many — one drachm, three times a day; but it is of 
first importance to correct the secretions and to regulate the diet. 

Where the liver is in fault, some calomel, one grain every night 
for six or seven nights, and gentle aperients every morning. 

Some have succeeded in relieving the pain by giving one grain 
of extract of belladonna for three successive hours, during the at- 



FACEACHE— NEURALGIA— TIC DOULOUREAUX. 355 

tack. Soon after the third pill the pain began to subside. Dr. 
Hunt gives arsenic with great success. He gives it with bicar- 
bonate of potash, if there is any acid ; or it may be given with 
opium or belladonna. He begins with four drops of Fowler's solu- 
tion of arsenic, combined with eight drops of paregoric, and he in- 
creases the arsenic till symptoms of its decided action come on, 
which commonly happens when the dose has been increased to ten 
drops. These signs are dry mouth and gullet, pain and suffering 
in the stomach, and white tongue ; then discontinue the arsenic ; 
give farinaceous food, with nitrate of potash, three or four grains, 
and of Scheele's prussic acid, two drops, in some water. 

When the tongue is foul, farinaceous food (see page 85), till the 
stomach becomes less sensitive. Then the diet must be gradually 
more nutritious. 

Where the spine is affected, blisters to the back, and stim-ulating 
liniments.' 

An emetic before, or as soon as the attack has commenced, has 
done good service. 

In periodical attacks, an emetic, then a purgative, then quinine 
or arsenic ; but do not give arsenic if there is a red loaded tongue, 
or if the urine lets fall a copious sediment. Look to the teeth 
always. 

I would give muriate of ammonia, thirty grains, three times a 
day ; and when one remedy fails, another should be tried. 

For external applications, the aconite, or its alkaloid. 

Aconitine is most likely to deaden the pain ; one grain of acon- 
itine to sixty grains of cerate may be rubbed into the part ; vera- 
tria in like quantity. 

If the pain continue long, put a small blister, or raise a blister 
with nitric acid, as before recommended, in page 253, and dress 
the blistered surface with acetate of morphine, three grains ; lard, 
half an ounce. • 

The author has ordered, with considerable effect, the liniment 
composed of soap liniment, two ounces; cyanuret of potass, ten 
grains, and of extract of belladonna, forty grains ; rub in, the size of 
a nut, two or three times, at intervals of an hour or less. 

The tincture of wild or Indian hemp, ten drops, three times a 
day, will often relieve. It causes feelings resembling those of in- 
toxication. 

The magnet has been of service. 



856 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Whatever seems wrong in tlie system should be corrected, if pos- 
sible to do so; but as this painful disorder often depends on organic 
and irremovable disease, palliatives are all that can then be re- 
sorted to 

Sprains. 

A strain signifies a violent stretching of tendinous or ligament- 
ous parts, with or without rupture of some of their fibers. Such 
an accident is followed by instant severe pain, so severe as some- 
times to cause faintness, and by swelling, to which succeed weak- 
ness and stiffness. 

If the accident is not treated properly, inflammation and fever 
may arise. 

Treatment. — Rest, absolute rest is necessary. Then apply warm 
fomentations or cold applications, whichever may be preferred by 
the patient. Leeches, low diet, purges, etc., if inflammation seems 
to threaten ; then, as soon as all heat and tenderness are gone, we 
must procure absorption, and restore the strength of the part by 
rubbing with various stimulating liniments, such as this : Of liquor 
of ammonia, two drachms ; of soap liniment, one ounce. 

My favorite application is iodine, either rubbed in, in the form 
of ointment, or else painted over tiie parts by means of a brush. 
Of iodine, thirty grains should be put into one ounce of alcohol, or 
spirits of wine. It leaves a walnut-liquor colored stain on the 
skin, which goes off after a time. This is a cleanly application, not 
troublesome, and only requires to be painted on every night, or 
night and morning. 

The ointment is thus made : Of iodine, thirty grains ; iodide of 
potassium, sixty grains ; lard, two ounces. Mix. 

Hand-rubbing, moderate exercise, and bandages. 

A succession of blisters has been found necessary, in some ob- 
stinate cases. * 

Scalds and Burns. 

These are usually divided into three classes : 
1st. Burns producing mere redness. 
2d. Those causing vesication, little bladders on the part, 
3d. Those causing the death of the part burned. 
The symptoms of those of the first class are mere superficial in- 
flammation, which goes off, or, as the medical men say, terminates 



SCALDS AND BURNS. 357 

in resolution, and the outer skin or cuticle peels off, or it may not 
do so. 

In the second class, the inflammation excited is in a hig-her 
degree, and the true skin exudes serum and forms vesicles, which 
vesicles, in slight cases, dry up and heal ; but if the injury is fol- 
lowed by suppuration, or the formation of matter, they will, prob- 
ably, be succeeded by obstinate ulcers. The pain here is much 
more severe than in the former case, especially if the vesicles 
have been torn, and the surface of the true skin exposed to the 
air and to the contact of foreign bodies. The formation of these 
vesicles may often be prevented by proper treatment; they gen- 
erally appear immediately after the accident, although they, in 
some rare cases, do not rise for three days. 

The third class of burns is attended with mortification, from dis- 
organization of structure. There is less pain, but the consequences 
are very serious ; for the sores which remain after the mortified 
parts have separated may remain for months and years before they 
heal. 

Constitutional symptoms are, a great sinking of the powers 
(collapse, it is called) ; the surface is pale, the pulse quick and 
feeble ; violent and repeated shiverings ; the sufferer complains 
of cold. 

In fatal cases, laborious breathing, (5oma, and death succeed ; 
while in others the fatal event is preceded by signs of an imper- 
fect reaction, the pulse and heat of skin recovering from the shock 
a little ; to these succeed delirium and sharp pulse. 

In burns, blood is driven from the surface to the interior ; hence 
the frequent consecutive inflammations of brain, lungs, pleura, 
stomach, or of bowels. When these inflammations occur early, 
the serous membranes are found to have suffered ; when late, as 
in chronic cases, the mucous. 

Burns of great extent ^e always dangerous, and those on the 
body are more dangerous than those of an equal extent on the 
arms or legs. There is more danger, too, in the extremes of life — • 
in infancy and old age. 

The pain may be violent, and so tend to exhaust ; but a total 
want of pain is more unfavorable, especially when accompanied 
by drowsiness and apathy ; for it is as if the scale of sensibility 
had shrunk below the point of pain. Constant shivering, coldness 
of legs and arms, a livid hue of skin, accompanied by drowsiness, 



358 AMERICAN HOUSEHOLD BOOK OP MEDICINE. 

and twitchings of muscles are alarming symptoms, and the invar- 
iable forerunners of death. 

Burns may prove fatal at three periods — in the stage of collapse 
or sinking, in that of reaction, and at any subsequent period. 

The first period may comprise about five days, the second will 
comprise more or less time, according to the state and the organ 
inflamed; in the third, death ensues from the exhausting suppu- 
ration which has drained the sufferer. 

In some cases, ulcers have been formed in the bowels, after se- 
vere burns. 

Treatment. — Great debates and discussions have been expended 
on the question w^hether Kentish's stimulating plan of treatment, 
or that by ice and cooling applications, be the better plan ; but 
we must aim at the following objects : 

1st. That the first applications should be of a mildly stimulating 
nature. 

2d. After the first two or three days, they should be soothing. 

3d. Slight astringents may be apphed. 

4th. The part must be carefully excluded from the air. 

The treatment may be divided into the local and the constitu- 
tional treatment, to which succeeds that of the ulcers. 

Local Treatment of Slight Cases. — In slight cases of the first 
and second degrees, the little bladders should be pricked with a 
needle, to let out the serum ; then the burned part should be cov- 
ered with lint soaked in a liniment of equal parts of oil and lime- 
water, and then be wrapped in soft cotton-wool. 

After the first two or three days, a zinc lotion may be applied 
on lint, and covered with oil silk ; or a poultice, or the water- 
dressing ; after these, the chalk ointment. 

Chalk Ointment. 

No. 163. Chalk, finely powdered 1 oz. 

Olive oil 3 drs. 

Lard i oz. 

Mix. 

To defend the parts from exposure to the air, many plans of 
treatment are recommended. Cover with collodion, or bathe the 
part with tepid oil of turpentine, or alcohol, or ether (which may 
be warmed by putting them into a tea-cup immersed in boiling 
water), then enwrap with lint or cotton. 



SCALDS AND BURNS. 359 

If the cooling plan be preferred, cold water, iced water; pounded 
ice mixed with lard, potato poultice, or grated turnip ; but when 
cooling applications are preferred, they must be renewed often 
enough to keep up the sensation of cold. 

Carron oil, composed of equal parts of linseed oil and lime- 
water, is much recommended ; its smell is a great drawback. ^ 

Flour, sprinkled over the part with a dredgery'or soft and finely- 
carded cotton, are very useful applications. They are to be strewed 
on in thick layers, so as to soak up, absorb the discharge. But 
these are apt to become dry, hard, and irritating ; and maggots 
may get in, or putridity be induced. 

Warm vinegar may be applied for the first twelve hours, then 
poultices till matter is formed, then afterward chalk. 

Severe cases require bathing of the parts with tepid turpentine ; 
then put on quickly lint, spread thickly with this liniment : 

No. 164. Ointment of resin 1 oz. 

Oil of turpentine ^ oz. 

Mix. 

Over these warm flannel. 

So long as no bad smell or profuse discharge ensue, these may 
be retained. When to be taken ofi", great care is necessary not to 
bring the skin with them. 

The constitutional treatment must be adapted to the state. If 
collapse is urgent, give stimulants, such as hot brandy and water, 
beef tea, ammonia, the ethers, etc. 

If less severe collapse be present, the stimulant and supporting 
plan must be modified accordingly. 

Opium is forbidden by many, on account of its tendency to add 
to congestion in the brain ; but if there be much pain, opium can 
not be dispensed with, but must be given. To children, 20 to 120 
drops of compound tincture of camphor may be given, according 
to age. 

In the fever that follows, the bowels must be kept gently open, 
and the diet must be unirritating, but not too low. 

If inflammation or congestion take place in head, chest, or ab- 
domen, we must treat accordingly. (See Inflammation of those 
parts.) 

Tenderness on the right side, in the liver region, or vomiting, may 
indicate irritation or ulceration of the bowel, into which the stom- 
ach leads ; here farinaceous and mildest diet should be the rule, 



860 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

with two or three-grain doses of mercury, with chalk powder and 
some two grains of henbane powdered, two or three times daily. 

The ulcers which are left are often very difficult to heal, but it 
is supposed that too stimulating a diet is often kept up to restore 
the strength ; and thus irritation is induced, rendering the ulcers 
more difficult to cure. 

There are various applications to ulcers ; when the discharge is 
profuse, very finely-powdered chalk should be sprinkled over the 
ulcer. An ointment of carbonate of magnesia is useful. 

But after all these dangers have been happily got through, the 
scar or cicatrix left after the burn has to be dealt with. This 
cicatrix becomes hard, dense, and cartilaginous (like gristle), and it 
is apt to contract, so as to occasion the most distressing deformi- 
ties and difficulties ; nor will repeated operations remove the ten- 
dency, even when every portion of the contracting texture has 
been cut away. 

This tendency to contraction would seem to depend on the struc- 
ture of the portion replaced. The cuticle or outer skin covering 
the cicatrix is very thick — thicker than the healthy cuticle ; this 
is the chief difference between the healthy cuticle and the replaced 
cuticle ; but there is a material difference in the deeper-seated true 
skin, as it may be called. The replaced true skin is composed of 
an exceedingly thick, strong, and inelastic band of fibrous tissue, in 
which only the smallest trace of the existence of the curly fibers of 
the yellovf elastic fibrous tissue can be traced by the microscopist. 

It is this latter element of the fibrous tissue of the healthy true 
skin which gives it its great elastic property, whereas the cicatrix, 
after a deeper burn, is composed entirely of a dense interweaving 
of the fibers of the white inelastic fibrous tissue. 

I have had to treat some frightful cases of these contractions, 
where the forearm has been gradually drawn up to the arm, and 
the limb rendered useless in one who had to labor for her bread ; 
and this, notwithstanding she had the intrepidity to undergo three 
painful and tedious operations, in the days when chloroform was 
not used. In another case of burn of the whole of the forepart of 
the neck, the angles of the mouth were drawn down, and the chin, 
until the latter was fixed to the chest. These accidents happen 
to cottagers' children, for the most part, who are left in a room with 
an open fire, without any guard, yet a guard might so easily be 
provided. 



COLD— FROST-BITES— CHILBLAINS. 361 

The contraction may sometimes be successfully opposed by keep- 
ing up extension with a splint, or, in case of the neck-burn, by a 
stiff collar, and by frequently moving the part during cicatrization, 
the scar being frequently lubricated with oil. If the fingers are 
burned, lint should be interposed between them, though they will 
still often adhere together. In burns of head or face, the ^dges 
should be drawn asunder by strips of adhesive plaster. 

Still, in spite of all, contraction occurs ; then the surgeon's knife 
must be resorted to, and even this is ineflScacious, unless the oper- 
ation lately recommended by Dr. Mitter can be performed, of di- 
viding the cicatrix, dissecting it up wherever adherent, and dividing 
muscular fibers when necessary, and then filling up the gap with 
sound skin, by what is called the Taliacotian operation ; that is, by 
transplanting a portion of sound skin from some neighboring part. 

Cold — ^Frost-bites — Chilblains. 

A person exposed to an intense degree of cold — and if that cold 
be accompanied with wind, which, as it passes, robs the body rap- 
idly of its heat, and if the person be, moreover, exhausted by hun- 
ger, fatigue, or by watching — will first feel an irresistible desire to 
sleep, and the sleep terminates in death. 

Great congestion in the veins is thus produced. 

In a frost-bite, the part becomes of a dull red color, and then 
the part becomes lividly pale, insensible, motionless, and muck 
shrunken. There is no local pain to warn the sufferer, and, in cold 
climates, a frost-bitten person requires to be told that his nose, etc., 
is dead. 

Now, a frost-bitten part may either mortify without any signs of 
inflammation having arisen, or inflammation may arise, which be- 
comes too violent, and so cause gangrene. 

The degree of cold requisite to induce frost-bite, must be 10° be- 
low the zero of Fahrenheit's thermometer. 

The power of resisting cold depends in a great degree on the 
temperament. The soldiers of France and Italy bore the cold of 
Russia, when fighting under Bonaparte, better than did the Dutch 
and other inhabitants of cold climates. 

Treatment. — Frost-bites should be rubbed with snow, then with 
cold water, in places not heated by fires. If this be judiciously 
done the part recovers, with only slight swelHng or tingling in the 



362 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

part, perhaps the formation of vesicles, with a scaling off of the 
scarfskin. The part remains, however, weaker and more sensible 
to cold than before. 

To combat the sleepy or comatose state, we should rub with 
snow ; then, after sensibility is restored, with dry flannel. Put the 
sufferer into a bed in a room not heated by fire, throw up an in- 
jection of water and salt, and of oil of turpentine, and give some 
wine and water as soon as the power of swallowing has returned. 

After these, mild cordials and nutriment. The great thing is to 
avoid inducing too high an action — inflammation, in short. 

If a frost-bitten part be injudiciously and suddenly exposed to 
heat in any shape, gangrene is almost sure to follow, and the part 
may become black and dry in a very short time. 

The best treatment here would be by applying snow or cold 
water, and then evaporating (spirit) lotions. These may prevent 
the gangrene ; and if the gangrene be already formed, they should 
be used as long as the mortification seems to be spreading. 

Then poultices and stimulating ointments must be resorted to. 

Chilblains occur readily when a part previously very cold is ex- 
posed too suddenly to heat; it is an inflammation without power 
of resistance in the part. 

They may be classified, according to degree, into a kind with the 
skin red and slightly swelled, with more or less of itching, ting- 
ling, pain, and lameness ; a second kind comprises those attacks 
attended with vesications, and a bluish or purple skin; and a 
third, in which there are ulceration and mortification. 

The toes, hands, nose, and ears are most frequently attacked, 
and women, children, and persons of languid circulation are the 
greatest sufferers. 

Treatment. — In all the degrees I have been, I may say, uni- 
formly successful by applying iodine, if applied to early enough. 
I employ a tincture of iodine, 30 or 35 grains of iodine to an ounce 
of alcohol. 

To an ounce of this I add ten grains of cyanuret of potassium. 
With this the part affected is painted over by means of a camel- 
hair brush, or feather-end of a quill. 

This application, however, must not be made over any part of 
the skin which is ulcerated, but only on the skin surrounding the 
open part. 

The itching and swelling are speedily reduced, even by a very 



DISEASES OF THE HEART— PALPITATION. 363 

few applications. These applications should be made not oftener 
than once at bedtime, and, perhaps, in some severe cases, once 
again in the morning. 

The stimulant applications which have been recommended are 
numerous. Six parts of soap liniment with one of tincture of can- 
tharides, mustard, turpentine, camphorated spirit, ammonia, fric- 
tions with new brine, and opiate applications have all been, in 
turn, strongly recommended ; but the iodine is the best applica- 
tion. ^ 

When there are vesications, do not break them. 

For ulcers or gangrene, with heat and pain, poultices are requi- 
site; then, after a time, stimulating ointments or lotions, as the 
zinc oiniment, and others of the same class. 



Diseases oe the Heart — Palpitation. 

■ This disorder is characterized by strong, sometimes violent and 
tumultuous, movements of the heart, so strong as to be felt and 
heard by the patient, or seen by those who are near at the time. 

A feeling of anxiety and distress, referred to the region of the 
heart, is usual, and sometimes fainting ensues. 

Causes. — Females are more disposed than men, yet a good 
many men suffer who are of nervous temperament, or who have 
been subject to nervous diseases, hypochondriasis, melancholy, 
and epilepsy. Debility predisposes strongly. 

The exciting causes it is important to know ; for our treatment 
must depend, to a certain extent, on such knowledge, some of the 
exciting causes being curable. 

Strong emotions, joy, anxiety, fear, sadness, anger, and violent 
exercise; debility, whether caused by exhausting diseases, or in 
any other way ; excessive loss of blood, or great increase of nat- 
ural discharges, abuse of purgatives, "bad diet, abuse of intoxicating 
drinks, want of sleep, deep concentration of thought, dissipation 
of all kinds, excessive use of all kinds of pleasure, confinement in 
an impure air, or in close or crowded rooms. 

Chlorotic females (from stoppage of courses) suffer much from 
palpitation. Spinal irritation it frequently accompanies, when 
there will be several other symptoms to point out the constantly 
acting cause, viz. : pains in the back, shooting forward or down- 
ward, or in various directions, and they may be increased, to- 



S64: AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

gether with increasedly violent palpitations, by tight stays, etc. 
Pressure, or gentle tapping with the knuckles, will often point out 
the disordered point of the back. This kind of palpitation is com- 
mon in females between the ages of fifteen and twenty-five. 

Palpitations, which often set in previous to or after the com- 
mencement of the monthly periods, will again appear in females 
about the period of the cessation of this periodical monthly dis- 
charge, and they will attack those who labor under diseases of the 
womb, breasts, ovaries, or who are siiFering from some wearing 
chronic ailment. 

Persons may suffer for years from palpitations without any sen- 
sible effect for the worse appearing; but so violent an action of 
the heart, as may be witnessed in these fits of palpitation, does 
not continue for many years without inducing some organic changes 
in the heart, which may become much enlarged in its substance, 
and more and more violent in its impulses ; while, at the same 
time, the disturbed heart's action may set up congestions, or de- 
terminations of blood to various organs, from which congestions 
diseased states spring forth, under which life sinks overpowered. 

In all nervous palpitations, the urine is frequently copious and 
of a pale color, and the heart is usually quietest when the sufferer 
is taking exercise in the open air, or the mind is fully occupied. 

Indigestion is, perhaps, of all causes, the- most frequent, and 
some patients are never troubled with flatulence without a violent 
attack of palpitation, with possibly an intermittent pulse, follow- 
ing the dyspeptic state. 

Palpitation is also one of the early symptoms of pulmonary 
consumption. 

Simple palpitation without organic disease, may be distinguished 
from that attending organic disease, by the complete cessation of 
all distress after the fit is over. 

Treatment. — This must vary with the state of the patient. In 
very full-blooded individuals, bleeding from the arm may be nec- 
essary, and cupping or leeching afterward ; then lowering or nau- 
seating doses of tartar emetic, one-eighth or a quarter of a grain, 
three or four times a day ; but vomiting must not be excited, if 
avoidable ; digitalis, or foxglove, or hydrocyanic acid should be 
given. 

The local applications are plasters of opium, belladonna, hen- 
bane, or hemlock. 



DISEASES OF THE HEART— PALPITATION. 365 

Low diet, repose, and quiet — both of mind and body — and ape- 
rients are requisite. 

But palpitations in the nervous, delicate person demands very 
different treatment. Here preparations of iron, a nourishing diet, 
tonics, with change of air and scene, are necessary. With these 
tonics we must combine sedative medicines, which frequently, are 
followed by very beneficial effects, as : 

No. 165. Dilute sulphuric acid 10 to 15 drops. 

Tincture of opium 5 drops. 

" of digitalis 5 to 12 drops. 

Infusion of gentian 1 oz. 

Two or three times a day, or : 

No. 166. Carbonate of ammonia 5 grs. 

Tincture of opium 5 drops. 

Camphor mixture 1 '5z. 

Or this: 

No. 167. Spirits of sulphuric ether 20 drops. 

Tincture of opium 5 drops. 

Carbonate of ammonia. 3 grs. 

Syrup 2 drs. 

Water 1 to 1 J oz. 

No. 168. Chloroform 20 drops. 

Tincture of foxglove 10 drops. 

Syrup 1 dr. 

Distilled water 1 oz. 

To be taken directly the palpitation comes on. 

Other prescriptions can be given of a similar character; but 
when palpitation accompanies a disordered stomach, the patient 
should never be without the following drops : 

No. 169. Tincture of cardamoms ") 

Spirits of ammonia (sal volatile) . . >- of each J oz. 
Liquor of potash j 

Tincture of opium (unless opium 

usually disagrees, then omit it) 60 drops. 

Hydrocyanic acid (of the Pharmacopoeia) 12 drops. 

Keep this in a well-corked bottle and in a cold place, wrapped 
Tip in a paper. The dose is a tea-spoonful in water or mint-water, 
or camphor julep, and syrup may be added, to taste, at the time 
of taking. 

One great object is, to assure the nervous sufferer, if we can 
truthfully do so, that there is no fixed heart disease, and that she, 
or he, may live for years, and need not be expecting the moment 



366 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

to arrive when she may be cut off by sudden death. Nothing 
tends more than this assurance will to relieve the mind of gloomy 
apprehensions. The mind and body should be kept quiet ; for 
any violent agitation of the one, or exertion of the other, is sure 
to aggravate the mischief, and many a sudden death has been 
caused from violent mental emotion, when there has been organic 
disease, as well as from bodily exertion. 

Several applications of a sedative kind will sometimes tranquilize 
in a great degree : 

No. 170. Soap liniment 20 oz. 

Extract of belladonna, or of aconite 1 dr. 

Cyanuret of potassium .' 10 grs. 

Rub two tea-spoonfuls of this over the region of the heart, and 
repeat according to circumstances. 
Chloroform may be applied also: 

No. 171. Chloroform 2 dr. 

Soap liniment 2 oz. 

Mix. 

Rub in a dessert-spoonful once or twice during the palpitation. 

The belladonna plaster has been serviceable. It is made by 
melting in a water-bath extract of belladonna and soap plaster, of 
each three drachms. 

Some have been frightened by an intermittent pulse, but inter- 
mission of the pulse often attends while the person is perfectly in 
health, and the pulse becomes regular only when disease is set up. 
Others, again, are alarmed by a pulsation at the pit of the stomach 
which resembles aneurism, and which has sometimes deceived med- 
ical men. This pulsation often depends on indigestion, and a gas- 
distended state of the large bowel, which runs across the body from 
right to left, just behind the pit of the stomach, and we may often 
remove the pulsation by a single effective purgative. 

Darting Pain, or Neuralgia of the Heart. 

This darting pain does not affect the breathing nor the circula- 
tion, as the disease called angina pectoris does; nor is it accom- 
panied with the pain, which shoots to the arms and down to the 
fingers, in angina pectoris. 

This is a nervous pain, and is more frequently dependent on 



STRUCTURAL DISEASES OF THE HEART. 367 

indigestion than any thing else. Strong tea has been supposed 
to have brought it on, when it has been drank to excess. The 
treatment is similar to that for palpitation. 

Structural Diseases of the Heart. 

' ■% 

These are very important, and demand the most energetic and 
judicious measures to be adopted without delay. But no one but 
medical men can correctly make out the exact site and nature of 
these diseases, for auscultation, or "sounding," by the stethoscope 
is essential. 

We will put down the chief distinguishing features, so far as 
that can be done without the stethoscope. 

The first is inflammation of the bag in which the heart is con- 
tained (the pericardium), and its inflammation is called pericarditis. 

Pericarditis, or Inflammation of the Bag containing 
THE Heart. 

This is generally connected with rheumatism. 

Shiverings at first ; then pain, more or less acute, under the left 
nipple, and toward the lower part of the breast-bone ; this pain 
extends toward the left armpit and arm, and down the left arm to 
the elbow or wrist. The pain may be darting, or else dull, and 
some complain not so much of pain as of a feeling of oppression. 
When it is present, deep pressure between the ribs, close to the 
breast-bone, will increase, or even cause it to be manifested, when 
no pain was previously complained of; lying on either side will in- 
crease the pain. 

Violent and irregular palpitations are manifest on placing the 
hand over the heart. 

Fever attends ; a pulse full, frequent, hard, regular, and jarring, 
or it may be a small, irregular, unequal, and rapid one; there is 
great shortness of breath, with a sense of terrible oppression and 
restlessness, and a want of fresh air ; the skin may be dry and hot, 
or bathed in sweat; the countenance pale, and expressing great 
terror. 

Further symptoms are sighs, sobs, hiccups, convulsions, delir- 
ium on awaking from sleep, frightful dreams, or else no sleep at all. 

The breathing becomes more and more laborious, the counte- 



AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

nance livid, the eye glassy, the skin covered with a clammy sweat ; 
the agonizing anxiety increases, until death frees from further suf- 
fering. 

This disease may terminate in recovery, or in a chronic form of 
the disease, or in death. But complete recovery is rare ; for the 
two surfaces of the membrane lining the heart, and the interior of 
the bag, may throw out fluid, forming dropsy of the pericardium, 
or they may adhere to each other, thus forming a heavy drag on, 
and impediment to, the future free movements of the heart. (See 
Chronic Pericarditis.) 

Causes. — The predisposing causes are hereditary tendency to 
gout and rheumatism. The male sex, from twenty to thirty years 
of age, are most liable. 

The exciting causes are cold, and, as already has been said, the 
extension or the transfer of the rheumatic or gouty action to the 
heart. 

Treatment. — This should be as vigorous as the foe is dangerous 
to life. The inflammation must be subdued with as much rapidity 
as possible ; after which we must promote the absorption of effused 
matters. 

If the patient be strong, bleed from the arm to the extent of as 
many ounces of blood as can be borne without fainting; then cup- 
ping or leeches ; but if the patient have been debilitated or lowered 
by the preceding rheumatism or gout, then cupping or leeches, and 
no blood from the arm. 

Give directly these powders, until the gums become red and ten- 
der, and begin to swell, with foul breath : 

No. 172. Calomel 3 grs. 



Opium 



:r. 



Or of Dover's powder 5 grs. 

Every second or third hour. If the powders purge, give more 
opium, or some of the astringent medicines recommended in Di- 
arrhea, the object being to prevent the mercury from running off, 
as it is called, by the bowels, for then it will not act specifically 
against the inflammation. 

Tartar emetic, a quarter of a grain, may be added to each pow- 
der with benefit. 

If rheumatism be present, twenty drops of tincture of colchicum 
seeds may be given every four hours. 

The diet must be low. 



CHRONIC PERICARDITIS. 369 

A blister to the cliest-bone, and the vesicated surface may be 
kept open by dressing it with savin cerate, a common preparation 
of druggists. 

Chronic Pericarditis. 

This generally follows the acute, and similar symptoms are^pres- 
ent — difficulty of breathing, palpitation, uneasiness or slight pain 
in the heart's region ; the person lies only on the right side ; low 
fever or hectic, debility. A serous or watery fluid is effused into 
the bag surrounding the heart. 

Treatment, — Cupping and leeches ; bhsters with calomel and 
opium, as above stated. If rheumatism be severe, give twenty 
drops of colchicum, as was advised above; if debility prevail, a 
more generous diet, with ammonia, alkaline bicarb onates every 
three or four hours, will be proper. 



Water in Pericardium. 

The signs of this state are obscure. Weight or oppression in the 
region of the heart is complained of; there is difficulty in breath- 
ing, and the sufferer is obliged to sleep in a sitting or erect pos- 
ture; for, if he attempts to lie down, he feels as if he were about 
to be suffocated; the face becomes of a dusky, livid, or bluish hue ; 
there is a tendency to faint, the ankles swell, and the pulse is fre- 
quent and irregular. 

Now the causes of this effusion have been either inflammation 
or some mechanical obstruction to the circulation of the blood 
through the heart and lungs. 

Treatment. — The ordinary treatment pointed out in dropsy must 
be followed here. We must give both sharp purgatives to bring 
away the serum or water, and we must resort to diuretics to get 
rid of it, through the kidneys. 

Elaterium is one of the most active expellers of watery motions 
we can employ, its great drawback being the distressing sickness 
which so often, and in some cases invariably, follows it. 

Still, such are its effects, that many patients bear the suffering 
of sickness in order to have the water expelled. 

A quarter of a grain of elaterium, with a little opium, or a drop 
of creosote, or a drop of hydrocyanic acid, should be given, and 
repeated according to effects. 
24 



870 ' AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Cream of tartar is another good remedy — half an ounce or more^ 
in the course of the day, mixed with ginger and sugar, and plenty 
of water. 

Epsom salts, half an ounce with a drachm of tincture of jalap^ 
once or twice daily, will procure watery motions. 

Diuretics are of various kinds : 

No. 173. Acetate of potash 30 grains. 

Spirits of nitrous ether 40 to 60 drops. 

Infusion of horseradish or of broom., IJ oz. 

Three or four times a day. A pill at night. 

No. 174. Blue pill .,..,.,') 

Compound squill pill >■ of each 20 grains. 

Compound soap pill j 

Make twelve pills. Two of these to be taken every night. 



Inflammation of the Heart. 

The inner membrane is here inflamed, and the signs are those 
common to heart diseases — anxiety, oppression, and fainting ; no 
pain usually ; skin hot and dry ; thirst, restlessness, fever. 

The heart's action is violent and irregular; the pulse may be 
small, feeble, and intermitting in some cases. The anxiety, rest- 
lessness, difficult breathing all become very distressing, and the 
face quite livid. 

Treatment. — When this serious disease is not fatal, it may leave 
behind it deposits on the valves of the heart, which, in course of 
time, prove very embarrassing, and abridge the sufferer's life. 

The treatment may be gathered from what has been said in 
Acute Inflammation of the Pericardium — ^bleeding, either gen- 
eral or local, and repeated according to necessity ; cupping, leeches, 
the warm bath, rest; the calomel powders, so as to touch the gums; 
issues or setons. 

Diseases of the Yalves of the Heart. 

To distinguish disease of the valves, and more especially to dis- 
tinguish which valves are affected, requires a knowledge of aus- 
cultation, and the general symptoms all resolve themselves into 
such as arise from the impeded circulation of blood through the 
heart, and from the effects of this impediment — namely, a drop- 



ENLARGED HEART— HYPERTROPHY. 371 

sical effusion — the dropsy appearing first in the legs, but after- 
ward in the chest or belly. 

Treatment. — AYe must regulate our treatment by the varying 
states of the patient ; but our treatment must be gentle, and there 
is no occasion here to try and salivate, for inflammation has dis- 
appeared some time. 

In some cases of urgent dropsy, I have relieved the patient 
"wonderfully, for a time, by acupuncture, which means introducing 
needles into the dropsical swelling at different points. If the needle 
point be introduced in a rotatory manner, no pain nor annoyance 
will be felt; when the needle is withdrawn, a drop of fluid ap- 
pears from each puncture, and in a few hours much fluid drains 
away, to the relief of the breath. 

Enlarged Heart — Hypertrophy. 

Symptoms. — Palpitation, with a strong, upheaving impulse ; the 
pulse will be full, strong, and frequent, in one kind of enlarged 
heart, and it will be small in another. 

Slight difficulty of breathing, increased on exertion; a good color 
in the face ; in severe cases there will be headache, giddiness, flushed 
face, bright eye, and signs of blood being determined to the head, 
and discharges of blood from the nose, or from piles, appear oc- 
casionally. As the disease advances, there may be a puffiness of 
the face, and the swelling extends to other parts. 

Causes. — Violent and straining exertions, too great fullness of 
the blood-vessels in the body, emotions of the mind, long-continued 
palpitations, certain chronic diseases of the lungs. 

Treatment. — This disease may continue a long time. 

Perfect rest of mind and body must be enjoined. According as 
the attending signs require, the diet should be spare, and blood 
may occasionally be taken away to relieve difficulty of breathing, 
or to diminish the great impulse of the heart. Sedatives are useful, 
as. 

No. 175. Bicarbonate of potash 20 grs. 

Tincture of opium ^ . . . 5 to 12 drops. 

" of digitalis (foxglove) . . 5 to 10 drops. 
Distilled water 1 ounce. 

Two or three times a day. 

Belladonna liniment, or plaster, will sometimes allay the inor- 
dinate action of the heart. 



372 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



Atrophy of the Heart. 

As enlargement proceeds from an increase of substance of the 
heart, so this atrophy depends on a thinning of its fibers. The 
heart's pulsations are small and feeble, and the upheaving or im- 
pulse is weak and feeble to the hand. Great tendency to fainting. 

Causes. — The male sex predisposes — age about fifty; habits of 
intemperance ; exhausting diseases. 

Treatment. — Nutritious diet — tonics, steel, infusion of gentian, 
quinine, or stimulants, sal volatile, ammonia, etc. 

There is no cure, so we must watch most carefully to prevent 
mischief. 

Dilatation of the Heart. 

In this complaint the cavities called the ventricles are dilated, 
and the symptoms are those indicating difficult transmission of the 
blood through the lungs and heart. 

It is caused by debility, by diseases of the lungs, and by long- 
standing valvular disease. 

Treatment must be adapted to the predominating state ; if there 
be much fever or excitement, lower the system cautiously by gentle 
aperients, a modified diet, diuretics, and saline medicines; but if 
debility prevail, and the difficulty of breathing seems to depend 
on some debilitating cause, then support with a nutritious though 
non-stimulant diet — allowing wine, if it seem necessary. 

Rest and quietude are indispensable adjuncts to treatment; and, 
in most heart diseases, the patient will do well so to arrange his 
dwelling that he may have no stairs to ascend or descend at any 
time. 

The Blue Disease. 

The color of the skin, lips, and mouth is blue; the skin is every- 
where cold ; there are fits of great difficulty of breathing, which 
seem very alarming ; palpitation is frequent ; feeble and irregular 
pulse ; fainting on slightest exertion, or on the mind having been 
excited; dropsy, too, is an attendant. This state depends on the 
existence, from birth, of a communication between the two sides 
of the heart, which is usually closed up after birth, and which 
admits venous blood into the left side of the heart without going 
through the lungs. The result is usually death during a fit of 



ANEURISM— INFLAMMATION OF THE VEINS. 373 

dyspnoea, at an early age, though some cases are on record where 
the sufferers have attained the age of fifty-seven. 

Treatment is obviously palliative — rest of body and quietude of 
mind, pure air, warm clothing, cautiously regulated diet, careful 
attention to the functions of the stomach and bowels. 



Aneurism. 

This is a sac filled with blood, and communicating with an ar- 
tery, by the rupture or dilatation of which it has been produced ; 
some disease of the artery has preceded. If it is situated on a 
limb, it appears as a pulsating tumor or swelling in the course of 
an artery. 

But it may be situated within the chest, near the heart, or within 
the belly; it there produces symptoms characterized by signs of 
pressure on, or irritation of, the neighboring parts. The aneur- 
ism and its site are often very difficult to be made out satisfac- 
torily, and the treatment is chiefly surgical. The subject is men- 
tioned here only to caution those who are so afflicted, or who have 
reason to suspect such a state, to maintain as perfect repose of 
mind, body, and of the part itself, as may be possible ; to observe 
temperance, and keep up a free state of the bowels ; to meet ur- 
gent symptoms, such as difficulty of breathing, by a small bleed- 
ing; or to keep down palpitation, or too great an action of the 
heart, by giving of either of tincture of foxglove and henbane, or 
colchicum, ten drops of the former, and twenty or thirty of the 
latter, two or three times a day, and locally by belladonna plaster. 

Belladonna liniment, or an embrocation of chloroform, may be 
rubbed in night and morning — a teaspoonful of either. 

Inflammation of the Veins — Phlebitis. 

An inflamed vein, when superficial enough to be visible, appears 
to the eye as if a knotted cord were running up the leg in the 
course of a vein ; the line becomes red, and painful on pressure ; 
the parts around swell; and if the attack be acute, fever soon 
makes its appearance — and of a typhoid character, too. 

This fever is more particularly deadly in those cases of phle- 
bitis which supervene on injuries and wounds after childbirth, and 
after surgical operations. 



874 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

After repeated shiverings^ profuse sweats, coma, great debility 
and anxiety, a weak, freqixent, and often intermitting pulse, a yel- 
low, muddy-colored skin, profuse vomiting and purging, and speedy 
death. In other cases symptoms are often very mild, and the con- 
stitutional affection is trifling. 

The matter, in those instances of inflamed vein which follow 
wounds, childbirths, forms what are called consecutive or second- 
ary abscesses ; and they are situated variously — sometimes occupy- 
ing a joint, sometimes the head, chest, or belly; in which event we 
shall have delirium or coma, with fever, if the head is the chosen 
site ; or we shall have difficulty of breathing and cough, if the 
chest ; and pain or tenderness in the belly, if the belly. 

The accompanying febrile symptoms are of a deeply typhoid 
character, and rapidly run their course. 

Sometimes the joints are the sites for the deposition of matter. 
Inflamed absorbents may be mistaken for inflamed veins in the 
limbs ; but the vein feels like a large, hard, and knotted cord, run- 
ning in the course of the vein ; while inflamed absorbents appear 
like hard, red lines under the skin, leading to a gland. 

Causes. — A bad habit of body predisposes; scrofula powerfully 
disposes ; or too low a state of the vital powers ; wherefore it is 
now very unusual to lower the powers of patients by bleeding, 
hasty meddling, etc. 

Cold, and previous injuries or surgical operations, or childbirth, 
are efficient causes. 

Treatment. — We may hope for recovery when the case has been 
excited by cold, and has originated in a good constitution; but sec- 
ondary abscesses are usually fatal if they form internally, though 
they may be managed often when they form in the external parts 
or the joints. 

We must adapt our treatment according to the state of the gen- 
eral symptoms. In mild cases, leeches in the course of the vessel 
maybe applied; but the lancet must be avoided. Gentle aperi- 
ents, salines, cold applications or warm fomentations to the part, 
whichever of the two may be most agreeable to the patient. 

If the accompanying fever be inflammatory, the calomel, opium, 
and tartar emetic powders : 

No. 176. Calomel 20 grs. 

Tartar emetic , 1 gi"- 

Opium, powdered 5 to 8 or 10 grg. 



RECTUM— STRICTURE OF. 375 

Mix and divide into ten powders. One three times a day, until 
tlie gums become tender. With these powders, saline medicines. 

But if the fever be typhoid, then wine, brandy, ammonia, cam- 
phor, ether, etc., with opium at night. The constitution must be 
boldly supported, the more typhoid the symptoms are. 

Sometimes calcareous concretions form in veins, by dege:^era- 
tion of the clots or coagulated blood within them. 

These are called phlebohtes, and must be removed by the knife. 

Yeins also become varicose, and cause so much swelling of the 
limb as to prevent walking; they cause ulcers to form, and a vein 
becomes thin, and bursts, when a hemorrhage or bleeding ensues 
from the part, and even becomes fatal. 

Treatment is either palliative or curative; the former consists of 
measures calculated to prevent further distension, and to induce 
contraction of the vein. 

If one or two veins are affected, apply pieces of leather, spread 
"with soap plaster, firmly over them; but if many smaller veins 
are enlarged, the whole limb should be supported with a calico or 
India rubber bandage, or with a laced stocking, which should be 
taken off every night on lying down, and reapplied every morning 
before leaving the bed. 

Friction with a flesh-brush, or with gloves, or with various lini- 
ments, may help the cure ; but the pressure, in rubbing, should be 
always in the direction of the vein. 

The bowels should always be kept rather open; hard motions 
and the consequent straining are very prejudicial. 

If, in spite of all these, the disease progresses, then the sur- 
geon must take the case in hand. 

Eectum — Stricture of. 

This intestine is the lowest bowel in the body, and a mechanical 
obstruction in it is often a fertile source of distress. Stricture of 
the rectum has been divided into spasmodic and organic, the latter 
forming a permanent obstruction to the passage and expulsion of 
the excrementitious matter. 

There are frequent and sudden calls to stool — two, three, or 
more, every day. The patient feels as if the bowel urgently re- 
quired emptying; yet, after much straining, nothing but a little 
wind, with mucus or blood, can be passed ; but, every two or three 



876 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

days, fecal matter, in the shape of small pellets, of hard consist- 
ence, and in long, round, angular, or flattened portions, of small 
diameter, if soft, is discharged. 

This state may last a certain time without much constitutional 
derangement ; but, at length, the patient loses his appetite, and 
becomes pale, emaciated, and hectic. 

The stricture is commonly situate at from two and a half to four 
inches from the outward opening. 

Treatment. — This disease is, by many, left exclusively to surgi- 
cal management ; yet there are, doubtless, many cases where med- 
ical treatment is of the highest value. It is very probable that 
a never-ceasing use of irritating purgatives may have given rise 
to the first tendency to contraction or stricture. 

The bowel has been kept constantly empty, and in an irritable 
state, by the purgatives, thus depriving it of the natural dilatation 
which is effected by the fecal matter lying in and passing through 
the bowel. 

"We may try gentle laxatives, such as castor-oil, manna, cream 
of tartar, lenitive electuary, or the infusion of senna and gentian 
combined. 

With these, injections of unirritating nature, to wash out the 
bowel. Mechanical dilatation by a candle or a bougie is often 
requisite ; but the introduction of a bougie requires care and cau- 
tion, as does also the gradual increase in the size of the bougie 

Fissure of Rectum. 

■ This painful disease commences insensibly in some cases, more 
rapidly in others. 

The passage of the stools is attended with heat and smarting, 
and, as the fissure increases, with violent pain, which often con- 
tinues for a long time after every motion ; indeed, the pain may 
hardly cease at all, and it is often increased by coughing, by any 
exertion, or when making water. 

On separating the lower orifice, while the patient is straining, 
a narrow cleft may be observed, with its bottom red and its edges 
slightly swollen and hard. A very painful spasm of the circular 
muscle of the anus is an accompaniment, and adds greatly to the 
suffering. 

Treatment. — Cure is usually affected by dividing the fissure; 



PROLAPSUS OF THE EECTUM. 377 

Btill, great relief has been given, and a cure has been effected by 
remedial means. A belladonna ointment may be rubbed in exter- 
nally, every night and morning ; it should consist of sixty grains 
of extract of belladonna and seven drachms of spermaceti cerate, 
or any fimple ointment. Sir Benjamin Brodie objects to the use 
of belladonna smeared on a bougie, or thrown up as a lavem^t, 
because, when thus administered, it has acted injuriously on the 
brain. He gives aperients to prevent hard stools, directs a bougie 
to be introduced before going to the water-closet, and orders an 
opium suppository at night. 

Opiate Suppository. 

No. 177. Powdered opium 1 or 2 grs. 

Soap or spermaceti 10 grs. 

Mix, by beatiDg. 

Prolapse of the Rectum. 

This is a bearing down and protrusion externally of the lower 
bowel, after each motion. 

Considerable hemorrhage (bleeding) attends, so that the disease 
is considered to be piles, until accurate examination of the pro- 
truded portion demonstrates the nature of the affection. 

Treatment. — Here again the surgeon's knife is called into requi- 
sition ; yet there is no doubt that much good may be done by as- 
certaining the cause or causes which have originated the disorder, 
and by removing them. 

All straining must be prevented by giving gentle laxatives, at- 
tending to the diet, that it be uniiTitating, and not leaving a large 
residue to pass through the bowel. When the bowel is down, we 
must return it by gentle pressui'e on the center of the prolapsed 
part ; but if this latter be too swollen, hot, and reddened, then 
apply a piece of muslin on the tumor, wetted with equal parts of 
tincture of opium and of sulphuric ether, and allow a rapid evapo- 
ration to take place. This, Dr. Copland says, he has never known 
to fail, especially in the cases of children. 

The general health must be attended to, and the secretions and 
excretions kept in as healthy a state as possible. 

To give tone to the bowel, and prevent its descent, throw up 
cold injections into the rectum, each containing sixty drops of 
the tincture of muriated iron. 



378 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Fistula in Ano 

usually demands the surgeon's aid ; but still much good will be 
effected by regulating the bowels, diet, etc. 

Gonorrheal 

The urine is secreted (formed) in the kidneys ; thence it de- 
scends down a tube, called ureter, on each side, into the bladder ; 
from the bladder it is discharged externally through a passage 
called urethra, the latter passage varying from eight to eleven 
inches in length. 

This latter passage — the urethra — is often inflamed, and the dis- 
ease is called urethritis. It is then very irritable, and there is 
much pain on making water. (See Inflammation of Urethra.) 

But there is a specific inflammation of this passage, caused by 
contagion, mostly from some impure or diseased woman, when a 
vicious or drunken man has exposed himself to it. This disease 
is called clap, or gonorrhea, and its symptoms are, first, an itching 
at the external end of the passage ; the itching becomes pain, 
especially on making water, and there is usually some swelling ; 
then a discharge of a whitish color, more or less thick, which be- 
comes yellowish or greenish, if there is much inflammation. 

Uneasiness and pain are felt along the course of the passage, 
and blood is sometimes discharged. If the uneasiness extend to 
the bladder, then the symptoms of irritable or inflamed bladder 
are added, or inflammation and abcess may take place in surround- 
ing parts. The urine comes out in a smaller stream than usual. 

Treatment. — Drink a tumblerful of water, or barley-water, five 
or six times a day ; and if some eight or ten grains of carbonate 
of soda or potash be added, so much the better. Live low; no 
meat ; and either fomentations or cold lotions, or cold-water cloths 
to the part will be useful. 

Keep the parts clean, and free from discharge ; take an ape- 
rient every second day. After a few days, when the pain and 
scalding are diminished, take twenty to thirty drops of balsam of 
copavi, three or four times a day, in water, made into an emulsion 
with some powdered gum arable. If these drops increase the 
pain, discontinue them, and treat as for inflammation. (See In- 
flammation OF Urethra.) 



VENEREAL DISEASE. 379 

No exercise should be taken ; rest is necessary to prevent local 
inflammation. If the discharge continues after the pain and scald- 
ing are gone, try an injection, night and morning, of sulphate of 
zinc, thirty grains to a pint of water. The fluid need not be 
thrown far along the canal — four or five inches are enough. 

For sudden pain at night, called chordee — or whenever it'*oc- 
curs, as in some cases it is a frequent attendant, and causes great 
distress — a draught of twenty drops of tincture of meadow saiFron, 
and ten or fifteen of the tincture of opium, in an ounce or two of 
water, should be given every night, or even three or four times a 
day, according to the violence or frequency of the attacks, for four 
or five days, taking care to prevent costiveness from the opium 
by giving an occasional aperient. 

Venereal Disease. 

This also arises from contagion, and, if neglected, may lead to 
great mischief. 

A small pimple usually first appears on the foreskin, which be- 
comes an ulcer, or an ulcer appears under the foreskin. This ulcer 
seems as if scooped out of the part, and has usually a hard, cir- 
cumscribed edge. 

Sometimes inflammation shows itself around the ulcer. A swell- 
ing of a gland in one or both of the groins may follow. 

Treatment. — As soon as the ulcer is seen, put lint wetted and 
kept wet with water on it, and cover the lint with oilskin. Take 
five grains of blue pill three times a day, till the gums begin or are 
about to swell, or become tender. If these pills seem to act on the 
bowels, a quarter of a grain of opium should be added to each pill, 
the object being to affect the constitution with the mercury, and 
not purge the bowels. 

If the bowels continue to be purged, discontinue the pills, and 
rub into the inside of the thighs, every night, sixty grains of mer- 
curial ointment, until the gums show the effect of the mercury, 
then stop; use gargles to the mouth, and take sarsaparilla drink, 
or bitters mixed with camphor julep. Under this treatment the 
ulcer heals, and there may be an end to the disease. 

But sometimes inflammation attends to a considerable degree, 
and, in some warm chmates, is of a very threatening character^ 
having a strong tendency to mortification. 



380 AMERICAN HOUSEHOLD BOOK OF" MEDICINE. 

In such cases, the inflammation must first be reduced, by poul- 
tices, or fomentations, or leeches ; low diet, rest, and purgatives. 
(See Inflammation and Mortification, Chapter lY.) 

The swelling in the groin must be treated with cold lotion, and 
sometimes with leeches applied near the swelling, so as to prevent 
it from softening and forming matter; but if matter do form, it 
should be let out, and a poultice applied. 

Usually, as the gums become tender, the swelling subsides. 

In some constitutions, the poison is aborbed into the system, 
and what are called secondary symptoms follow, viz. : sore throat, 
and ulcers in the throat, or dark, copper-colored eruptions on the 
skin. When this happens, a gentle mercurial course may become 
necessary ; and the sarsaparilla drink must be taken, a pint a day. 

Whenever a person is taking, or is under the influence of mer- 
cury, care must be added to avoid catching cold. 

Stricture. 

It is necessary to mention this disease, which is a contraction, 
permanent or temporary, of one or more parts of the urethra, and 
may endanger life by causing a total retention of urine in the blad- 
der, requiring often an operation by a surgeon. 

Symptoms. — The earliest symptom is the retention of a few 
drops of urine after making water; then some irritability of the 
bladder, causing the person to make water often in the night. The 
stream of urine is forked, spiral (corkscrewy), flattened, or scat- 
tered, or it may come away even in drops. 

If any error in diet be committed — if acid drinks, old or sour 
beer be taken — a spasmodic stoppage may occur, and no water be 
expelled at all, while the bladder is making distressing efforts. 
Stricture follows a clap, or gonorrhea, sometimes. 

There are two kinds of stricture in the urethra — the spasmodic, 
which arises suddenly, from error in diet or cold; and when the 
spasm goes off, the urine is expelled in as full a stream as usual 
in health. The other kind is the permanent, and, in that case, there 
exists a permanent obstruction to the flow of the urine, the urine 
always flowing out in a small and impeded stream. But some- 
times a spasmodic state is suddenly superinduced upon the per- 
manent stricture or obstruction ; then great danger often arises, 
and nothing short of a surgical operation will relieve. 



Enlargement of the prostate gland. 381 

Treatment. — The spasmodic kind is to be treated hj warm bath, 
rubbing in some liniment or ointment of belladonna, all along the 
passage underneath. A bougie must be tried to be passed throuo-h, 
while in the bath, but if it will not pass, do not persevere, or the 
part will be irritated. 

A bougie is made of linen, rolled into a circular form, and dipped 
into wax mixed with lard ; it is flexible, and well adapted to pass 
all along the urethra. 

In the permanent stricture, our reliance must be on the bougie, 
and a small-sized one must be passed (gently, so as not to cause 
pain) through the stricture (or obstruction), at first once a day, or 
once in two days, and allowed to remain for six or eight or ten 
minutes, and the time lengthened to half an hour, or an hour at 
last, or even longer. After the small one passes easily, try to in- 
troduce one the next size larger, in the same manner, until a full- 
sized one, No. 13, can be borne, and that will suffice. 

Some persons can never make w^ater without previously intro- 
ducing a bougie ; and if its use is left ofi*, the stricture may return. 

Care as to diet — nothing irritating, no acids or sour drinks ; all 
intemperance is dangerous, all excesses, all irritations. The bowels 
are to be kept gently open always, and the urine well diluted by 
water or barley-water, and some thirty grains of carbonate of soda 
or potash will be useful, night and morning, or after dinner, or the 
effervescing draughts. 

Enlargement of the Prostate Gland. 

There is a gland situated at the neck of bladder, and it may be- 
come enlarged, which generally happens in elderly people, and in 
those disposed to scrofula. 

Clerks in offices, who lead a very sedentary life, often generate 
a predisposition to this disease, and the discharge called clap some- 
times causes this gland to enlarge. 

The symptoms are some difficulty in making water, with, per- 
haps, pain. This difficulty progresses as the gland continues to 
enlarge, and the bladder makes more and more powerful efforts, 
until at last it can retain but little urine ; there is a sense of un- 
easiness or weight low down in the perinaeum (that part of the 
body on which we sit), and if a bougie, or any similar instrument, 
be introduced, it will pass readily till it reaches to near the entrance 
into the bladder. 



382 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

There are other modes of ascertaining this enlargement, but 
they require the practical knowledge of the surgeon. 

Treatment. — Generally, all we can do is to remove irritation or 
inflammation (if either exist), by warm baths, leeches, and fomen- 
tations to the perinseum, and to keep the urine as unirritating as 
possible^ by the alkalies and diluting drinks ; twenty grains of car- 
bonate of potash or soda, every night and morning, in a tumbler- 
ful of water, will prove serviceable. The diet must be carefully 
looked to. 

I was once called to an elderly man, who had been a barrister's 
clerk all his life, and who was in a comatose state, from the urine 
having been retained too long without a surgical operation. He 
had for years suffered from enlargement of the prostate gland, and 
the fatal attack was brought on by his incautiously drinking only 
one glass of old beer, which was rather sour. Spasm was added 
to the mechanical obstruction, which always existed. No opera- 
tion was proposed till it was too late to save life. 

The barrister, with whom this gentleman had lived for many 
years as clerk, died also from this disease. Sedentary habits in 
both were the causes in action. 

Men so affected must take care what they eat and drink. 



DISEASES OF WOMEN. 383 



CHAPTER V. 

DISEASES OF WOMEN 

It is proposed here to describe and treat those diseases pecu- 
liar to the female sex, and which have not been described in the 
preceding pages. 

We must bear in mind that women are endowed with great sus- 
ceptibility to nervous excitement; and that, although we must 
treat fevers or inflammations occurring in them on the same gen- 
eral principles as those which have been laid down — namely, those 
of lowering action in the usual way, or of supporting, when sup- 
port may be necessary — still, we must not forget that they do 
not bear active measures, of a certain character, so well as men; 
and that although there may often be a show of high and threaten- 
ing inflammatory symptoms, yet there is a want of sustaining 
power, which will prevent blood-letting and other exhausting means 
being recovered from so rapidly as in the parallel case of the male. 

Cancer in the Breast and Womb. 

This fearful disease has been treated of in the preceding chap- 
ter, as far as general principles are concerned. 

And, first, of cancer of the breast. 

It commences generally as a hard, circumscribed, movable swell- 
ing in the breast, which is so painless as to have escaped atten- 
tion, until discovered by accident. After an uncertain time it in- 
creases in size, and the circumferential outline is irregular. And 
now the most distressing symptom of all is complained of ; namely, 
peculiar, violent, darting pains, which occur in fits or paroxysms, 
and more violent at the time of the monthly period. 

This pain is so unfailing an attendant on cancer, as to be con- 
sidered almost a diagnostic or. distinguishing characteristic ; still 



384 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

there are exceptional cases (probably very rare ones), in "whicli 
there has been no pain throughout the progress of the disease. 

The writer can testify to this, and also to the universal surprise 
and, he fears, concealed incredulity with which his description of 
the painless case was received. 

The nipple sometimes bleeds a few drops, and generally with 
local relief. And now the cellular texture around the swelling 
diminishes, so that the diseased breast becomes smaller than the 
sound one, while the nipple is retracted or drawn in, and the skin 
around it puckered. 

In some cases, this deposit of cancerous matter is general 
throughout the gland, and the whole breast becomes a hard mass. 

The swelling next forms an adhesion to the skin above, and to 
the muscles below the tumor. It becomes fixed and immovable ; 
then it ulcerates, and becomes open cancer. 

The glands in the adjoining armpit, and sometimes those in the 
neck, enlarge ; and hard lines, like cords, can be felt under the 
skin, running from the tumor to the glands. The bulk of these 
glands presses on the blood-vessels in the armpit, causing ob- 
struction to the circulation of the blood in the arm, whence the 
swelling, as if from dropsy, of the arm. 

The cancerous action spreads to the rib§ and to the chest ; fluid 
is formed, and diflSculty in breathing is added. 

The flesh wastes away, and the sufi"erer at length dies exhausted. 
According to Sir Astley Cooper, cancer requires from two to three 
years to attain its full growth, and life was usually destroyed in 
from six months to two years afterward. 

But, instead of a tumor, there may be felt around the nipple 
little knobs or tubercles, which extend to the skin of the head, 
neck, and shoulders, and soon become painful. At first they are 
of a red color, then a yellowish transparency occurs in the center, 
and then they do not form pus or matter, but they break and 
change into a corroding ulceration. 

The discharge from cancer, in every form, is very fetid. 

No injury or bruise, etc., is necessary to set this dreaded virus 
into action. 

It becomes of great importance to make out, decidedly, whether 
a tumor in the breast is cancerous or not ; for many are very 
hard, as hard as scirrhus, and yet are not of malignant nature ; 
but a stony, hard, movable swelling, in its early stage, and the 



CANCEB, IN THE BEEAST AND WOMB. 385 

slirunken gland and drawn-in nipple, afterward, are the signs of 
cancer. The age about forty; the sallow complexion, the weak- 
ness and bad habit of body, the darting pain ; and the history of 
patient's mother or sister having suffered will assist us in forming 
our opinion. 

Still, there are sources of fallacy against which we must gua^rd. 
The cancerous deposit may be attended with common inflammatory 
action in the parts surrounding ; then pain, tenderness, and swell- 
ing will be complained of, while the usual well-marked outline and 
hardness are no longer visible, and we may suppose the case to be 
merely one of chronic inflammation. 

Then, again, cancer may occur earlier than at the age of forty ; 
and also our remedies may so reduce the swelling as to make us 
fancy that the scirrhus, cancerous deposit has been removed. Of 
treatment we have spoken in the former chapter, and little satisfac- 
tion can we expect from the curative influence of medicines; still, 
nature, in some few cases, allows of a prolongation of life, and the 
cancer cells may, from some unknown cause, cease to propagate, 
when the growth would shrink, leaving a punctured cicatrix or 
scar ; or the cancer cells may undergo a fatty degeneration, or the 
cancerous deposit may, like the tubercular, undergo a change into 
a chalky or putty-like mass, with the skin puckered over it. 

Many a large, hard swelling has been mistaken for cancer, and 
the error would be of little consequence, if caustics of all kinds 
were not being continually applied, to the exhaustion and discom- 
fort of the sufferer. 

Treatment. — For the local treatment, pressure should be steadily 
persevered in ; and if this can not be borne. Dr. Arnott's intense 
cold should be tried ; and this cold seems to act both in producing 
a local anaesthesia or prevention of sensibility to pain, and in 
checking the progress of the tumor. 

The extirpation of the tumor will be alluded to after the de- 
scription of cancer of the womb. 

As to cancer in the womb, there is considerable chance of mak- 
ing mistakes. There is one polypous growth, called cauliflower 
excrescence, which is confounded with cancer; but any of the 
kinds of polypi in the uterus may, by their exhausting discharges, 
produce such general symptoms as would give rise to the suspi- 
cion of the presence of cancer, though the local symptoms do not 
correspond. 
25 



886 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

To attain the nearest approach to certainty, the medical man 
must use an instrument called a speculum, which enables him to 
see the neck of the womb ; while others can only guess that there 
is cancer at its destructive work, when a variously-colored dis- 
charge takes place from the vagina, which discharge is singularly 
fetid — indeed, so peculiar, that many a surgeon recognizes, almost 
at once, by it, the foe he has to deal with. Besides this discharge, 
there are the characteristic darting pains, which have been already 
alluded to. 

(Refer to the article on the Womb and its Polypi.) 

Induration, or hardening of the neck of the womb, has not un- 
frequently been mistaken for cancer, especially when pains have 
been present ; but the pain is not of the darting kind, which so 
invariably characterizes cancer pains. 

Treatment.— The general treatment has been mentioned, and the 
iodide of arsenic, in doses of one-sixteenth of a grain in a pill, 
two hours after dinner, and also twice a day — that is, in all, three 
times a day — is the remedy most relied on by the best authori- 
ties- — taking care of the bowels and of the secretions generally, 
by occasional aperients. 

The digestive functions must be kept in order by the infusion 
of gentian, with twenty grains of bicarbonate of potash, once or 
twice a day, between the pills. 

For the pains, morphia must be given with the pills— a quarter 
to half a grain or more in each pill, according to the influence 
they seem to exert — taking care not to do more than deaden the 
pain, and not to cause constant drowsiness. Some recommend 
henbane, belladonna, or hemlock, for this purpose. 

The smell from the discharge is so offensive, that injections 
must frequently be gently thrown up. The best is the follow- 
ing : 

No. 178. Sulphate of iron 20 grs. or more. 

Distilled water J- pint. 

Mix. 

For an injection, a fourth part to be thrown up at a time, and 
as often as may be necessary. If it cause pain, warm the fluid ; 
if still painful, add extract of hemlock, ten grains to the half-pint, 
and mix well by rubbing all together in a glass mortar. 

The chloride of soda is strongly recommended for this purpose, 
and may be thrown up frequently. The formula is this : 



BLADDER— FALLING DOWN OR PROLAPSE OF. 387 

Injection of Chloride of Soda. 

No. 179. Solution of clilorinated soda, made ac- 
cording to the United States Pharma- 
copoeia 1 oz. 

Distilled water 16 oz. 

As to excision or cutting away of the breast, or of a portion of 
the diseased neck of the womb, opinions have been much divided 
Dr. Vincent says, " The removal of unequivocal cancerous disease 
does not prolong life;" and Dr. Walsh says, "Excision can not 
be undertaken without imminent risk of putting the patient in a 
worse state than he or she was in before the use of the knife." 
Nevertheless, instances have been known of the disease not recur- 
ring after excision, and others, where life has been prolonged by 
the excision of an actively progressing cancer, while, ttanks to 
chloroform, the operation may be painless. 

Dr. Druitt seems to give the best directions, when he says : "An 
operation may be proposed to the patient (who should of course 
be informed of the precarious chance it affords) if the disease is 
movable and circumscribed, so that it can be cleared away by an 
operation with the knife. If, however, the skin is extensively 
tuberculated, and adherent to the scirrhus, if the surrounding fat 
and cellular tissue are implicated, if the tumor is firmly adherent 
to the parts beneath, if it is extensively ulcerated, or if the orig- 
inal disease is much less in degree than the coexistent scirrhus of 
the adjoining lymphatic glands, or if the patient's health is fast 
sinking, or if there is any palpable internal disease, the operation 
should not be attempted." 

A bleeding offensive mass may be thus got rid of, and an opera- 
tion justified, even though cure is out of the question. Excision 
may be effected in three ways : by the knife, and every part must 
be carefully cut away ; by caustic, in flat cancerous affections of 
the skin, or by a ligature. 

Preparatory treatment is requisite before, and care after the 
operltion. 

Bladder — Falling Down or Prolapse of. 

This descent of the bladder from its proper site may take place 
in various degrees. In extreme cases, I have seen what would 
have been thought the whole of the bladder protruding between 
the ihio;hs. 



888 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

The symptoms attending it are those resulting from irritation of 
the surrounding parts — pain, with bearing down; a discharge of 
whitish color from the vagina. As soon as the bladder has emp- 
tied itself, a sensation of ease will succeed. 

There is a strong desire to make water during the night, and 
while in the horizontal position. 

Both the womb and the bladder may fall down from their natural 
position, and they may remain in the vaginal passage, or they may 
protrude from the body ; the womb must be distinguished from the 
bladder by the orifice or mouth, which is at the lower part of the 
womb. The stomach, too, is said to sympathize more with the womb 
than with the bladder ; and nausea, vomiting, heartburn are often 
present when the womb is prolapsed, and absent when the bladder 
is alone affected. 

The only safe mode of distinguishing is, by an accurate exami- 
nation of the protruding part. 

Treatment. — As relaxation of the passage (the vagina) is usually 
the disposing cause of this prolapse, it is often met with in women 
w^ho have had large families ; and when to this relaxation of the 
passage violent straining efforts are added, as in hard stools or in 
violent coughs, this descent of the bladder is not improbable. Our 
indications of treatment are obvious — to give tone to the part, to 
avoid straining efforts, and to apply some mechanical support. 

The injeption of sulphate of zinc, and of alum, thirty to sixty or 
more grains of each, may be dissolved in a pint of water, and a 
portion thrown up two or three times a day. The oak-bark decoc- 
tion may be substituted for water. Then a pessary should be 
introduced, to support mechanically ; its form may be oblong or 
globular, and the former is best borne. 

The patient must herself discover what size and shape will best 
suit her, and the instrument must be occasionally gently withdrawn 
to be cleaned, and so returned. The zinc injection should be con- 
tinued all the time. ^ 



Prolapse, or Falling of the Womb. 

Here we have pains in the back, a sense of distension, or of the 
presence of some foreign body in the vagina ; a white, or more or 
less colored discharge is added ; the stomach suffers by sympathy, 
a sense of bearing down, and a frequent desire to make water, as 



PROLAPSE, OR FALLING OF THE WOMB. 889 

if the bladder were affected. I^ow, these two last symptoms are 
relieved by the horizontal posture, and are increased in the erect ; 
whereas, in the case of the bladder, the bearing down, etc., are in- 
creased when in the horizontal posture. 

Local relaxation occurs, and the blood-vessels, in some cases, 
pour forth blood, which might obscure the case, and make one sus- 
pect simply profuse menstruation ; that is, if no examination be 
made. This disease, if unchecked, may cause great mischief, and 
the womb will at length ulcerate, after long exposure to the air. 

Treatmeyit. — The strength must be supported by the usual means 
and all that seems wrong in the system should be corrected. 

The local treatment is important; the injection of sulphate of 
zinc and of alum should be perseveringly used, made as strong as 
can be borne without pain ; but the common uterine syringes of 
pewter, etc., are of little use. (See the article Whites.) 

But, before we resort to these astringents, we should reduce any 
tendency to local fullness or excitement, by giving rather low diet 
for three or four days ; gentle laxatives, by enjoining rest in the 
recumbent position for a few days, and by calming the system. 

Then the patient, having emptied the bladder and the rectum, 
must lie on the bed with legs and heels raised, and legs bent on the 
body ; and if she can not obtain a medical man's assistance, she 
may be able to help herself by putting back the womb with a gen 
tie though continued pressure on the center and lowest point of 
the prolapsed part. 

If much pain ensue, and the womb has been long down, or is 
protruding forth of the body, further attempts must be desisted 
from; and the patient may rest satisfied if she has succeeded in 
placing the womb within the body, thereby preventing much an- 
noyance, ulceration of the part itself, etc. 

In minor cases of prolapse, when the womb lies down on the 
floor of the perinaeum (the lower part of the body on which we sit), 
the part may be replaced readily enough ; but it would again fall 
down when the patient leaves the recumbent position. To prevent 
this falling down, it is necessary to place some mechanical sup- 
port in the passage, and this is called a pessary. 

Pessaries, as used now, are usually constructed of various sizes 
and forms ; some of which are circular, others flat, oval ; others 
globular or oviform ; and they may be made of vulcanized India 
rubber or of box-wood. 



390 AMERICAN HOUSEHOLD BOOK OF' MEDICINE. 

Many experienced practitioners object to the pessaries, and no 
longer use them ; and I can, against such a weight of authority, 
only mention my own experience ; but that has been so much in 
favor of them, that I do not hesitate to advise their use. That 
there are cases in which a pessary can not be worn without great 
pain and inconvenience, I am aware ; and, also, that much annoy- 
ance may result from not occasionally removing the pessary, clean- 
ing it, and replacing it the next morning, before rising from the 
recumbent position, while advantage might be taken to syringe the 
parts well when the pessary is not worn. Still, there are many, 
I would say the majority of cases, where pessaries are of the great- 
est service. I recollect one instance of a lady, the mother of a 
large family, who seemed to be in perfect, almost robust health, yet 
never could walk above a hundred or two of yards without being 
stopped by a sense of increasing weight and pain, and a straining 
desire to make water, which rendered her unhappy, and led to her 
never attempting to walk, to the surprise of all around her, for she 
seemed to be in perfect health, having a good color. Her natural 
delicacy prevented her from consulting any one, until one summer 
she became somewhat intimate with my wife, and to her the tale 
of concealed suffering was told. 

On being told, I, of course, divined that there was a prolapse of 
the womb. An examination was, after a time, consented to, when 
a prolapse was discovered, and a flat, oval box-wood pessary of 
proper size was introduced, and proper instructions how to manage 
it were given. 

The very next day, to the patient's great delight, and to the as- 
tonishment of those who had seen her for years most obstinately 
inactive, she, unknown to me, walked a long way, without any suf- 
fering, though a walk, or any exertion is always imprudent, not to 
say hazardous, till the parts have got accustomed to the presence 
of the foreign body. 

Another case was that of a poor washerwoman, with a large 
family totally dependent on the mother's labor, who consulted me 
for a prolapse, in which the womb was on the point of protruding 
into the open air. The poor woman could no longer stand at the 
w^ash-tub, and the family was much distressed. After a little pre- 
paratory treatment, I introduced a flat open pe'ssary, and the next 
day, and, indeed, every day after, she was able not only to stand 
at the wash-tub, but to do a day's work without inconvenience. 



THE WHITES, OR LEUCORRHCEA. 391 

The oval pessary should measure, in thickness, not less than 
one-third of an inch at its external edge, for otherwise the edge 
may cause injury ; and it should be gradually thinner as it ap- 
proaches the hole in the center. 

A surgeon should introduce it, but, as there may be no one 
near, or the patient can not conquer her repugnance to divulge-'her 
annoyance, she may try what is called a medium size first ; smear 
it with lard, put the finger into the central hole, and introduce it 
by its short diameter, till it fairly arrives at the end of the pas- 
sage ; then it should be gently turned so that each end of the oval 
may point toward the sides of the pelvis, with the hole facing the 
outlet. 

If the pessary chosen be too large, pain and irritation will de- 
clare the fact ; and if too small, it will either soon slip down and 
come awaj* of itself, or simultaneously with the first motion or first 
urine expelled. 

A clear-headed, courageous person may be quite able to man- 
age this matter for herself, and the comfort felt will soon show 
whether the pessary is properly chosen or properly fixed. Its 
presence will not prevent pregnancy, nor will the husband be 
aware, probably, nor need he know, of any thing of the kind being 
fixed there. ♦ 

There are some valuable mechanical contrivances to keep the 
womb in its place. They consist of something to project within 
the passage, which is connected with an apparatus fixed around 
the body, to which it is fastened. England's spring truss is a good 
instrument, where there is no rough work to be undergone, but it 
is necessarily somewhat expensive. 

A shield pessary, invented by Mr. Duffin, is recommended by 
several eminent medical men. 



The Whites, or Leucorrhcea, or Fluor Albus. 

This is a common complaint, and is often suffered to continue 
unopposed by treatment, because the sufi'erers can not overcome 
their repugnance to mention their state to any one. 

It is a light-colored discharge from the female genitals, varying 
in hue from a whitish or colorless to a yellowish light-green, or to 
a slightly red or brown color ; in consistence, from a limpid serum 
to a tenacious ropy substance ; and in quantity, from a slight in- 



392 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

crease of the liealthy secretion to several ounces in the twenty- 
four hours. 

This descriptive definition, given by Dr. Copland, is a very good 
one. 

This discharge may come from the vagina or from the womb. 
Leucorrhoea may occur at any period of life, from earliest infancy 
to advanced old age, but it is most frequent between the ages of fif- 
teen and fifty. In childhood and infancy, there is a general dispo- 
sition in the mucous membranes to be irritated or inflamed, and to 
furnish a copious mucous or mucopuriform secretion. After the 
age of fifty this disorder is seldom observed, unless there be some 
coexisting organic disease. 

The discharge may issue from the vagina, or from the womb it- 
self; when from the vagina, it is caused, when acute, by inflamma- 
tion. 

The symptoms are heat and soreness in the passage, with, fre- 
quently, itching externally; pain or smarting; bearing down. A 
discharge of a thin acrid fluid appears soon after these symptoms, 
seldom later than a day or two ; but soon it appears to get whiter, 
thicker, or yellower, more like pus or matter, and resembling cream. 

Pain in the back and loins, with languor, lassitude, thirst, quick 
pulse, costiveness, and high-colored urine, and smarting on pass- 
ing it, accompany or succeed the symptoms detailed above. 
■ This discharge is not increased before or after the menstrual pe- 
riod. Rich living, luxurious life and indulgence, may irritate the 
body. 

Treatment — in the acute stage is to bleed by lancet or leeches ; 
laxatives, warm baths. If the constitution is debilitated, give tonics 
and generous diet, and as soon as the local heat and swelling in 
the passage are subdued; then the injection of sulphates of zinc 
and alum. The creosote injection is useful. Of creosote, thirty 
drops ; spirits of wine, half ounce ; and seven ounces and a half 
of boiling water ; or introduce a piece of lint soaked in a liniment 
of Goulard's extract, Battley's laudanum, and mucilage of gum 
arable, equal parts of each. But the female syringes in common 
use are objectionable ; they are too small, and produce irritation, 
from the frequent necessity of withdrawing the pipe for the pur- 
pose of refilling the instrument. To the common domestic injec- 
tion syringe, a proper vaginal pipe should be fixed; and by this 
any quantity may be thrown up without removing the pipe. 



THE WHITES, OR LEUCORRHCEA. 393 

The fluid should be thrown up while the patient is in the recum- 
bent position, and, if it is desired that the injection be retained as 
long as possible, the hips must be raised by a pillow. The most 
portable apparatus is a gum elastic bottle, holding ten or twelve 
ounces, with a gum elastic pipe fixed into it, half an inch in di- 
ameter, and about three or four inches in length, rounded-at its 
extremity, and pierced with several holes. Where this is fixed to 
the bottle is an oval-shaped ivory shield, to which a soft piece of 
sponge is attached, and this is put to prevent the instrumeiit from 
being introduced too far, and also to assist in retaining the fluid 
injected. 

Medicated injections are never injected in sufficient quantity, 
says D/. Bull, or retained sufficiently long. 

With these remedies, we must look to the constitutional state, 
giving iron and tonics when the skin and complexion are pale, the 
digestion impaired, etc. The cold bath is useful, with dry rubbing 
afterward ; the cold douche on loin or hips. 

Cubebs and benzoin have been recommended. Perhaps, when 
the inflammatory tendency is gone, this is a good form : 

No. 180. Sulphate of quinine 10 grs. 

Dilute sulphuric acid 80 drops. 

Syrup of orange-peel 1 oz. 

Water ,... 7 oz. 

Take an eighth part, three times a day, of this tonic medicine. 
In the chronic form of vaginal leucorrhoea, the discharge is more 
or less colorless or whitish ; at times it is of deeper hue, being 
greenish, yellowish, or brownish, and now and then so acrid as to 
excoriate the tops and insides of the thighs. There is little if any 
increase of heat, and little or no pain or tenderness. The glands 
in the groin are not enlarged. Weakness, languor, and impaired 
digestion attend ; and the womb may at laftt be prolapsed from re- 
laxation of the passage. 

Treatment. — The acute stage we saw required lowering and 
quieting the system ; here tonics and astringents may be given at 
once. 

No. 181. Camphor ") 

Sulphur of quinine . . . , >- of each 20 grs. 

Sulphate of iron ) 

Extract of camomile 40 grs. 

Peruvian balsam enough to make thirty-six pills, two to be taken 
two or three times a day. 



394 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Decoction of oak -bark, the sulphates of zinc and alum may be 
used for injections, as before recommended. 

In some cases, this discharge is acting as a sort of safety-valve; 
then it would be dangerous to do more than check it; but it rarely 
happens that it acts as a safety-valve. 

Leucorrhcea from the Glands at Neck of Womb. 

This,is characterized by the whiteness of the discharge, by pain 
at the lowest point of the backbone, and by the state of the womb, 
when examined by the eye. 

The discharge is thick, white, and resembles a mixture of starch 
and water, without heat, or it looks like thin cream. It is readily 
whisked from the finger after examination, and is capable of be- 
ing diffused in water, which it does not render turbid. It is often 
much thicker than cream, and is very tenacious, and then requires 
to be squeezed out, by exertions to empty the bowels. By long 
continuance, this disease may bring on some still more serious ones ; 
and paleness, bloodlessness, costiveness, indigestion, etc., attend 
the later stages. 

The exciting causes are cold, great indulgence, hot, spicy, luxur- 
ious food, local excitement after marriage, feather-beds, late hours, 
balls, etc. 

Treatment. — Remove the stage of excitement by the usual 
means — cupping on loins or low down the back, hip baths, gentle, 
cooling laxatives, as the Seidlitz powder or cream of tartar, and 
inject tepid water or decoction of poppy-heads three or four times 
a day. 

When the chronic stage comes on, we can try gentle astrin- 
gents, such as have been already mentioned. 

Leucorrhcea from the Womb. 

Many have denied that whites can come from the womb; but 
this discharge has been found in the uterus after death, in a female 
who had labored under whites during her life. 

Like the other forms, there is an acute and a chronic stage. 

In the acute, there is pain in lower part of back, with sense of 
dragging in the hips, thighs, etc.; there are thirst, indigestion, 
and tendency to hysteric seizures. The discharge is sometimes 



LEUCORRHCEA FROM THE WOMB. 895 

copious, then stops; then is again discharged abundantly, giving 
decided relief. The constitution sympathizes, and all symptoms 
are aggravated at, or before and after, the menstrual periods. 
The discharge thickens into what is called pus or matter, in some 
instances. 

The chronic state is very common — languor, weakness in ISins, 
headache, paleness of face, and dark circle under the eyes, and 
increased discharge on, or before and after, the periods. When 
the periods seem to have been superseded by this discharge, all 
the symptoms become more severe, and pallor or sallowness of 
face, loaded, yellowish, or pale or sodden and flabby tongue, an 
impaired or fanciful appetite, with eruptions of acne on the face, 
all show the inroads made upon the constitution. 

The discharge varies much in quantity; sometimes it is profuse, 
mostly colorless and semi-transparent ; in others it is opaque, of a 
greenish, yellowish, or brownish tinge. It varies as to thickness — 
from a thin, watery mucus, to a gelatinous mucus, resembling the 
white of a raw egg, or a curdled-like matter. It is often very 
acrid. 

When neglected, the termination of this leucorrhoea may be in 
stoppage of the periods, sterility, consumption, and even dropsy. 

Treatment. — Here again we must be guided by the local heat, 
pain, and other signs of excitement ; wherefore cupping, leeches, 
hip baths, soothing injections of warm water, with cooling aperi- 
ents and diet, and every thing to quiet the irritation, are neces- 
sary. 

But in proportion as debility seems to prevail, we may give 
tonics, and nutritious, not stimulant nor too high seasoned, diet. 

No. 182. Citrate of iron 60 grs. 

Infusion of calumba, or of quassia. ... 12 oz. 

Two table-spoonfuls thrice daily. 

The iodide of iron, two grains thrice daily, when paleness and 
scanty periods are present. 

Many of the remedies called tonics have been recommended. 

The chalybeate mineral waters may be drunk. Tunbridge or 
Pyrmont waters, or Spa water. 

Sponging or douching the loins, hips, and back. 

Tepid injections of warm water, to wash away the discharge. 

We must use caution in ordering astringents, and they must 
at first be tried in very small quantities. The acetate of lead or 



396 AMERICAN HOUSEHOLD BOOK OF MEDICINE, 

Goulard water, the sulphate of zinc, etc., one or two grains to each 
ounce of water. A blister to loins is often useful. 

A properly regulated diet is of importance, and the daily habits 
must also be looked to. 

There are some watery discharges from the womb, which will 
be described further on, under the heads of Cauliflower Excres- 
cence and Hydatid. 

Menstruation — The Monthly Period. 

This is, perhaps, the most important change which the female 
constitution has to undergo ; and the difference between the girl 
in whom no menstruation has occurred nor is impending, and that 
same girl after it has been fully and happily established, is indeed 
truly striking. 

Some mothers are exceedingly foolish in sometimes wishing to 
force the period; and, having made up their minds that the age 
of fifteen or sixteen, etc., is the proper time, they ascribe often 
temporary ailment which may occur to the want of nature's own 
evacuation. 

One melancholy instance is related by Dr. Dewees, to whom a 
mother brought her daughter. He advised the mother to wait, and 
do nothing. She went to a quack ; medicines were given, fever, 
etc.. were set up; the quack told her to persevere, when death 
ensued. The celebrated quack medicine was the oil of savin. 

The age at which menstruation may occur varies between the 
ages of twelve and nineteen ; but fifteen is the age at which, it 
most frequently happens, and the duration of this function is thirty 
years generally. ' 

Management of the Menstrual Period. — Increased susceptibility 
and excitability attend this state. When the female is in good 
health, and the discharge is regular and natural in every respect, 
all that is required is the avoidance of any, or of all, those influ- 
ences which may prejudicially disturb the mind or body. 

All medicines or remedies should not be used at this time; no 
bathing, cold or warm, should be allowed if all is natural. 

Exposure to wet or cold is very dangerous ; and if the person 
is in the habit of using vaginal injections, she should not use them 
during and shortly before the period. Excessive exertion and 
riding on horseback must be interdicted. 



MENSTRUATION— THE MONTHLY PERIOD. 397 

Sexual intercourse must be totally forbidden ; for, wlien sucli 
a circumstance has happened, "it has been followed by profuse 
hemorrhage ; at other times by a suppression of the discharge ; to 
which have succeeded fever, delirium, hysteria, mania, and even 
catalepsy." 

Confinement in crowded, ill-ventilated rooms, deprivation of air 
and exercise, bad diet, etc., may cause disorders oimenstruation ; 
but a natural discharge in a healthy female requires nothing to 
be done by medicines. There may be some cases where the con- 
stitution seems, after a few periods, to require a little help in the 
shape of tonics, and a more generous diet. 

The period of the final cessation of the menses is variable. 

At no time during her life is a female under such fear and 
anxiety as at this, which generally takes place about the age of 
forty-five or forty-six. Yet it is not reasonable to think that any 
disease should *be a necessary consequence of the cessation of a 
discharge which is as perfectly natural as its appearance or con- 
tinuance. 

By many it is considered that the turn of life is the fatal period 
when serious and fatal disease is set up; so that when, as some- 
times happens, the quantity of the periodical secretion is dimin- 
ishing, prior to a total cessation, women are exceedingly uneasy, 
and often apply to have the secretion forced, as they call it. 
In this way disease might be induced which would never have 
occurred. 

It is supposed that cancer chooses this time for assault. Yet 
statistics do not confirm the supposition. 

Mens. Lisfranc, of Paris, tells us, with regard to this point, that 
"we are not to believe, with most writers on this subject, that 
affections of the uterus are more common at this period than at 
any other. The great law of physiology, that the more an organ 
is exercised the more liable it is to morbid affections, here holds 
good, as elsewhere. From thirty to thirty-five years of age the 
reproductive organs are most exercised, and observation shows 
that diseases of the genital organs are more common between 
those two periods. There are a great number of women, affected 
with diseases of the uterus, in the Hospital of La Petie ; and among 
those so attacked, I do not remark more than three who have 
reached the age of fc^rty." 

The truth is, that when disease has been formed, or there is a 



398 AMERICAN HOUSEHOLD BOOK OF. MEDICINE. 

tendency to some morbid action in the system, tlie cessation of 
the periods generally aids in aggravating the one, and in develop- 
ing the other ; and thus a disorder, too slight to attract attention 
during active menstruation, will assume an active and a rapid form 
when it ceases. 

Treatment. — This period of cessation is marked either by a di- 
minished quantity of the menstrual secretion, or by an excess of it. 

Now, the diminished quantity is the way Nature selects, and 
accordingly many females have less and less discharge at every 
period, when cessation is about to occur, until it ceases altogether; 
and this goes on so gradually as often to escape notice, for no 
unpleasant feelings or diseased manifestations occur. 

In such cases, there is no occasion for medicines ; but when 
there is an excess, we must diminish the quantity of the discharge, 
and try to prevent a return of excess. 

Rest, cool drinks, application of cold, and gentle aperients. If 
these fail, together with the horizontal positiop, we must resort to 
the powerful anti-hemorrhagics, such as the acetate of lead and 
opium, as recommended in spitting of blood. 

To apply cold to the belly, we should procure some large blad^ 
ders, half fill them with ice, cold water, or water in which there 
is some ice ; that is, if this happens during summer or hot weather; 
if in winter, cold water alone will suffice ; and keep these bladders 
applied. 

The legs and feet are to be kept warm, in order to draw or 
divert as much blood as possible from the inward part. 

The lead and opium pills or draughts may be given every three 
or four hours, according to circumstances ; that is, if the quantity 
of the blood discharged is very great, and is causing faintness, 
etc. ; but if the symptoms are not so urgent, then the sulphuric 
acid and alum medicine, as recommended in Hemoptysis, should 
be given. 

The plug is often applied in extreme cases ; to make it, we fold 
a soft handkerchief, dip it in vinegar and water, and put it up to 
the top of the bleeding passage, as far as it can be gently pushed. 
Some recommend a piece of ice to be inserted within the handker- 
chief. 

This plug may remain undisturbed for eight or ten hours ; but 
not longer. Every eight or ten hours il^, should be removed, 
cleansed, and reinserted, or another put in instead. 



GREEX SICKNESS, OR CHLOROSIS. 399 

To prevent a recurrence of this monthly flooding, we must teach 
the avoidance of whatever tends to excite mind or body, and some- 
times a few ounces of blood must be extracted by lancet, or by 
cupping-glasses to the loins, just before the period, if the person 
is of full plethoric habit, and has been once already attacked. 

Perhaps no remedy is so derivative, nor so useful in preventing 
thes'e attacks, as purgatives — such as an acidulous solution of Ep- 
som salts. 

No. 183. Epsom salts 1 oz. 

Sulphuric acid, diluted 80 drops. 

Tincture of cardamoms 3 drachms. 

Infusion of roses 8 oz. 

An .eighth part, once or twice a day, according to effects. 

In some cases, the patient has been obliged to be confined to a 
milk and vegetable diet. 

In some cases of cessation, the discharge continues for an un- 
duly long period, and yet with little discharge. Here we may 
give the bitter infusions, or the quinine. If necessary, a pill of 
acetate of lead and opium may be given occasionally, or for two 
nights successively. Directions how to manage these pills are 
given in the article HiEMOPTYSis. 

Finally, many women do not suffer heavily at this time ; yet 
they complain of flying pains, which resemble those of rheuma- 
tism ; also of headaches and hot flushes, etc. In such cases, one 
gentleman recommends, as sovereign remedies, sarsaparilla and 
rhubarb, with alterative pills, viz. : one Plummer's pill every night, 
for some eight or ten nights, then to discontinue for a week or 
two, and repeat. 



Green Sickness, or Chlorosis, or Amenorrhea. 

The blood is here altered in quality, containing less of the red 
particles and of its solid ingredients than it should do, while the 
secretions are also depraved. In some cases it depends on a want 
of development in the ovaria. These symptoms are languor or 
fatigue on slight exertion ; palpitations, pains in various parts, 
especially the side, loins, and hips; throbbing of arteries; signs 
of indigestion, such as flatulence, acidity ; a depraved appetite 
exists, and lime, chalk, pickles, acids, etc., are eaten when there 
is no desire for proper food. The lips, face, and skin lose their 



400 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

color, and assume a dusky, sallow hue ; a black or dark circle sur- 
rounds the eyes ; the feet swell and pit on pressure ; the breathing 
is hurried, the pulse is frequent and small in caliber, the mind 
depressed; the finger-nails dry, split, break off; hair falls off; 
hysteria in its various forms, with cough, dropsy, and, in some 
cases, hectic fever sets in. 

The pains in head or side, cough, etc., are so violent and fixed 
as to frighten, and give the idea of inflammation being set up in 
those parts. 

Treatment. — "We must try to restore the blood to a healthy 
state, and we must correct all the secretions that are out of order. 

Some stomachs will not bear the stronger tonics at first; they 
seem to give pain. Then I begin with infusion of calumba oa' gen- 
tian, with sal volatile, twenty to thirty drops, and some carbonate 
of soda, twenty grains. To this one drachm of Epsom salts may 
be added, when costiveness is present. The Epsom salts are 
omitted as soon as they have acted gently. Then a mixture of 
infusion of calumba, with three grains of citrate of iron, may be 
given. After this, other preparations of iron will be well borne. 

But, in all cases, an occasional dose of an alterative aperient is 
necessary, about once a w^eek. A pill, consisting of three grains 
of blue pill, and two of compound extract of colocynth, should be 
taken at bedtime, and next morning a dose of the black draught 
(salts and senna mixture), or a seidlitz powder, will answer in those 
who are not of too costive a habit. These aperients seem to set 
the bile flowing freely, and to clear the stomach and bowels, im- 
proving the digestive powers, and causing more healthy blood to 
be formed. 

Some prescribe aperients combined with tonics, such as aloes 
with the sulphates of iron and of quinine ; but I prefer to give 
them as above stated. 

The iodide of iron, two grains, with tincture of orange-peel, one 
drachm, and one or two ounces of water, three times a day, often 
acts powerfully. 

Hip baths — the waters of Driburg, Pyrmont, Spa, Carlsbad, or 
the Bath and Buxton warm springs, used as baths. 

Diligent hand-rubbing, with gloves made for the purpose — 
proper air and exercise. 

Troublesome symptoms are to be obviated, as best we may ; but 
of all, the pain in the side is the most general. 



RETENTION OR SUPPRESSION OF THE PERIODS. 401 

As it depends on the state of the womb in this case, it is not 
likely to be relieved in any other way than by the rehef of the 
original disorder. Still, poultices may be applied, over which 
powdered opium has been sprinkled ; or an instantaneous blister 
may be formed by nitric acid, as described in article on Cholera, 
and dressed with an ointment of morphine ; or the belladonna^ plas- 
ter may be applied, or the belladonna liniment rubbed in night and 
morning, or when in pain. 

The hysterical symptoms are also troublesome. For these, the 
compound spirits of ammonia, thirty drops in camphor julep, with 
a little tincture of ginger or of cardamoms, may be generally ser- 
viceable. 

Here the volatile tincture of guaiacum may be useful — thirty 
to sixty drops in milk, or milk and water, three times a day. 
Madder has been recommended ; but it is seldom, if ever, effica- 
cious. 

Where the green sickness depends on the non-development of 
the ovaria, we shall detect this state of cause by seeing that the 
usual signs of womanhood, of female development, have not made 
their appearance ; that the breasts do not become larger, nor the 
hips and thighs, and limbs acquire that full development and 
rounded form which characterize the healthy female. 

Here art is at fault ; for there is not sufficient light to guide 
our practice. 

As to giving savin, hellebore, ergot of rye, strychnine, rue, 
pennyroyal, and various other nostrums, which have been called 
specifics, I have no faith in them. Such as rue, and others like 
it, there can be no harm in trying; but savin, hellebore, etc., may, 
and often do, act like poisons. 

It is better to trust to perseverance in strengthening the con- 
stitution by every possible means, than to seek for those reme- 
dies so highly thought of by many an old gossip, and miscalled 
specifics. 

Retention or Suppression of the Periods — Amenorrhea. 

Here the periods may have commenced; but, from accidental 
cold, or some other cause, the discharge suddenly ceases ; and 
although the feet may be put into a warm bath, and other meas- 
ures may be taken, yet it does not reappear ; this is suppression. 
26 



402 AMERICAN HOUSEHOLD BOOK OF .MEDICINE. 

Or the time may have arrived for the usual secretion to appear, 
and it does not appear ; this is retention. 

This state of things may coexist with, or spring from, constitu- 
tional debility. 

The symptoms are those of debility and languid circulation, or 
of debility, with a deranged state of the blood added. 

The symptoms are, pale countenance, or else it is waxen, sallow, 
and muddy, the general signs of debility, of impaired digestion, 
and of nervous or hysterical seizures. 

Treatment is pretty manifest to those who have attended to the 
preceding directions. 

Hip baths, steel medicines, Griffith's mixture, or the compound 
iron mixture of the pharmacopoeia, occasional aperients or purga- 
tives. It is often a successful practice to apply a few leeches to the 
perinseum, about four days before the period is expected ; and this 
time may be known by hardness of the breasts, and by certain in- 
ward feelings of discomfort. 

The complications of amenorrhoea are very numerous, and must 
be treated as they arise. 

Profuse Menstruation — Menorrhagia. 

The quantity lost at each period is, on an average, about five or 
eight ounces; and this secretion proceeds from the lining mem- 
brane of the womb itself, and seems to consist of the elements of 
the blood, in an altered condition. It contains much red coloring 
matter ; but the albuminous and fibrinous constituents are present, 
probably in smaller proportion than in healthy blood. The coag- 
ulating power is wanting usually, when the secretion is not mixed 
with blood ; but if any clots appear, we may conclude that blood is 
also escaping from or near the secreting surface. A very small 
portion of surface is sufficient for this secretion ; for the womb of 
a young woman was examined after death, who had menstruated 
regularly and properly to the time of her death, yet the womb re- 
tained only a surface healthy enough to perform the menstrual 
function of the size of a finger-nail, all the rest of the interior of 
the womb being in a state of disease. 

The coagulation of the fibrine, normally present in the menstrual 
fluid, would seem to be prevented by its mixing with the vaginal 
mucus ; but when an increased amount is poured forth, this admix- 



PROFUSE MENSTRUATION— MENORRHAGIA. 403 

ture is not sufficient to destroy its power of forming a clot. In 
some cases of difficult menstruation, which seem to depend on a 
state of low inflammation in the womb, the fibrine has such a ten- 
dency to become organized, as to form shreds or layers of false 
membrane, which sometimes plug up the mouth of the womb. 

The menstrual secretion in health is remarkable for its very aicid 
character. 

A monthly discharge of less than four ounces may be considered 
as scanty ; of more than ten ounces, as excessive ; and this dis- 
charge may take place in gushes, or in the form of a slight, mod- 
erate drain. 

But, whatever the quantity discharged, the great and only point 
to be attended to is the effect upon the constitution. However 
excessive the quantity discharged may seem to be, it is doing no 
harm, and requires no meddling with, if the female is left in good 
health, and not in a state of debility and exhaustian. 

This disorder may be viewed under three heads : that in which 
the discharge is of natural character, but is excessive in quantity, 
or as respects its continuance or frequency of recurrence ; 2d, that 
in which there are clots of blood intermixed with the discharge, 
but without any change in the position or size of the neck of the 
womb ; 3d, that in which there is a change in size or position of 
the womb. 

Dr. Copland divides the disorder more correctly into true men- 
orrhagia, and into hemorrhagic monorrhagia. 

The first kind comes on in various ways, sometimes suddenly 
and abundantly, sometimes slowly, yet insidiously. Thus, the pe- 
riod may be quickly over, and yet so much secretion discharged 
as to produce considerable exhaustion ; or it may continue for two 
or (I have known instances) for three weeks, so that the sufferer 
was hardly ever free from this secretion for longer than one week 
at a time. 

Wliites often precede or follow this disease. On examining the 
passage, there are neither heat, tenderness, nor SAvelling. 

The accompanying symptoms are weakness, aching across the 
loins and hips, languor, exhaustion, singing in the ears, giddiness, 
headache, throbbings at the temples, and palpitations. The coun- 
tenance, lips, tongue, and gums are all pale. The stomach and 
bowels become deranged ; pains in the side, and the hardly ever- 
faihng attendant on womb irritation, the pain in the left side, are 



404 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

present; and as the cause continues to operate, the ankles swell, 
dropsy, looseness of the bowels, convulsions, and various nervous 
affections make their appearance. 

The second kind is monorrhagia, with discharge of pure blood 
or coagula. " This variety is met with," says Dr. Copland, " in 
married females chiefly, of a phlegmatic temperament, and in those 
who have been weakened by disease, or by frequent child-bearing, 
or by prolonged suckling ; and in these circumstances it is gen- 
erally complicated with whites." 

Active or inflammatory monorrhagia occurs in robust, full- 
blooded married women, who live fully, and indulge freely in every 
pleasure. The sense of heat, tension, and pain in the region of 
the womb is great, and the pains are so violent as to resemble 
labor pains. 

The discharge sometimes comes on in gushes with clots, and then 
the person feels relief for a time ; in others, a draining, more or 
less copious, goes on. The neck and mouth of the womb are hot 
and swollen. After the discharge has ceased, the patient is left 
weak, and, after many attacks, with her health impaired. 

The passive or chronic form may succeed the acute, or come 
slowly and gradually on. It occurs chiefly among the delicate, 
the hysterical, and debilitated females ; and the increase of the 
discharge may vary from a slight quantity to that producing the 
most severe prostration. The clots may be added gradually to the 
natural secretion, but they increase until they become numerous. 
Fainting and exhaustion ensue ; the back is weak and aching ; face 
and lips pallid ; pulse small, feeble, and quick ; and most serious 
symptoms result if the discharge be not arrested. 

Treatment of the first variety. — When the patient is robust or 
full-blooded, a free discharge is often salutary, and must on no ac- 
count be meddled with. General and local blood-letting, cupping 
on the loins, may be ordered when there is high action; but unless 
there be the most unequivocal evidence of tolerably high excite- 
ment, it will be better not to meddle ; but when this discharge 
occurs in the delicate, pallid, and hysterical, the recumbent posi- 
tion, spare diet, cooling regimen, and cooling astringents are de- 
manded. 

The cream of tartar, with infusion of senna, to open the bowels ; 
then infusion of roses, with sulphuric acid, may be given. 

The main dependence is to be placed on the sugar of lead 



PROFUSE MENSTRUATION— MENORRHAGIA. 405 

draughts, combined witli opium (see Spitting of Blood), or on 
the sulphate of zinc, with opium. 

The ergot of rje has been recommended, in doses of five grains, 
three times a day. 

Cold-sponging the loins, abdomen, and hips, and cold injections 
may be employed. 

Plugging the passage is not recommended here. 

For the pallid and delicate, the citrate of quinine and iron, or 
this mixture : 



No. 184. Sulphate of quinine 16 grs. 

" " iron '. 15 grs. 

Dilute sulphuric acid J oz. 

Syrup 4 oz. 

Water distilled Sf 

Mix. 



)f oz. 



Give one table-spoonful thrice daily. 

Chalybeate mineral waters, salt-water bathing, and cold shower 
bath are of great service. Avoid all causes, such as prolonged 
or excessive suckling, or cold. Light nutritious diet, and wine. 

The hemorrhagic form must be treated during the inflammatory 
stage, with depletions of blood, cooling aperients, preparations of 
antimony with opiates, acetate of lead with opiates, and ipecacu- 
anha and opium, when there is much pain or spasm. For pain, 
opiates at night, either in the form of Dover's powder, five to ten 
grains, or in the shape of what is called the compound soap pill, of 
which five grains every night may be taken. 

During the intervals a cooling regimen, spare diet, cooling aper- 
ients, local depletions, may help to prevent a recurrence of the 
congestion. 

In the passive state of this hemorrhagic form, or clotted profuse 
menstruation, as it may be called, we must apply the cold douche 
bath on the loins and hips, cold astringent injections, the recum- 
bent posture, and perfect quietude. 

It has been recommended to throw up a few drops of a solution 
of alum or of acetate of lead into the womb itself, by means of a 
male gum elastic catheter, which should be introduced gently ; the 
wire withdrawn, and a small syringe being adapted to the catheter, 
a few drops (say thirty or forty) of a weak solution of acetate of 
lead may be thrown in ; and the moment pain ensues in the back, 
the operator should desist. 



406 AMERICAN HOUSEHOLD BOOK OF MEDICINE 

This operation must not be attempted by any one but a surgeon. 
The medicines to be given are the sulphuric acid with alum mix- 
ture (see Hemoptysis), the acetate of lead, and opium pills ; and 
where the disease seems to depend on a diseased condition of the 
blood, the cream of tartar is described, by Dr. Sylvester, as en- 
dowed with extraordinary power over these discharges. 

Painful or Difficult Menstruation, or Dysmenorrhcea. 

This is a very painful disorder. It has been defined as men- 
struation, preceded and accompanied by acute pain in the belly, at 
its lower part, and often in the back or breasts, the discharge be- 
ing frequently scanty, or presenting morbid appearances. 

The suffering is often extreme, and pregnancy is often prevented 
by this state, or it may occasion abortion, if pregnancy has oc- 
curred. Married and single females are subject to it, the latter 
especially, and it may occur in all temperaments and habits of 
body. Most frequently we meet with it in woman of irritable, hys- 
terical, and nervous temperaments ; of spare, strumous, and con- 
sumptive constitutions. Its occurrence is favored by indolence, 
and by full or rich living. Exposure to cold, mental emotions may 
cause it. 

The amount and character of the pain may vary much — from a 
bearable amount of pain to such agony as to occasion fainting or 
severe retchings ; and it may accompany every period from the 
commencement of menstruation in life to the last period. 

This form of menstruation may be called neuralgic, and attacks 
chiefly unmarried females, or the married who have not borne chil- 
dren. It may appear at any menstrual age, but it is said to be 
most common about the thirtieth year. It is generally observed 
in nervous or hysterical and irritable temperaments, and in spare 
and delicate habits of body. 

The monthly paroxysms of pain have all the characteristics of 
neuralgia, as in tic-douloureux. They are often accompanied by 
headache, and the local pain begins at the lowest part of the back, 
spreading round the belly and to the thighs. There is a sensation 
of bearing down, and the agony is at times so great that the sufferer 
writhes about and tries various means of bearing the pain better. ^ 

After a certain time, some hours, or a day or two, a discharge 
commences, which at first is scanty, or comes in slight gushes; 



PAINFUL OR DIFFICULT MENSTRUATION. 407 

but the quantity is rarely great, though it varies in different indi- 
viduals. It is frequently natural in appearance, at times pale, or 
mixed with small clots, or with shreds, or with a brain-like matter. 

The membranous shreds, which are passed, consist of plastic 
lymph, formed within the womb. They may be thrown out in one 
piece, and shaped even like a triangular bag, as if it had "been 
molded upon the interior of the womb, and its expulsion is at- 
tended with violent forcing pains, not unlike those of labor. This 
discharge of membrane may accompany every period successively, 
or only occasionally. There is another form of this painful affec- 
tion, which is attended with inflammatory symptoms, viz. : flushes, 
succeeded by chills, headache, and feverishness ; some time before 
the discharge, the skin is hot and pulse frequent, with constipation. 
These subside as the discharge proceeds ; but the pains are vio- 
lently bearing down, when clots or coagula, with portions of mem- 
brane, are expelled. A white discharge remains after the colored 
one, further weakening the sufferer. 

Between the attacks, the health may remain pretty good, al- 
though whites may remain constantly. 

Females who thus suffer are said never to conceive ; this is not 
true in every instance. 

Some have mistaken the membranes expelled for portions of 
those membranes which -are formed during conception, but the for- 
mer are of a dirty white or yellowish color, after moving them freely 
about in water; neither do they possess the soft, pulpy appear- 
ance and reddish color of the conception membrane; nor have 
they any of the little bags which distinguish this latter ; neither 
are there any of the little holes for the entrance of blood-vessels 
which are found in the pregnancy membrane. The latter is also 
a double membrane. 

This disorder may not materially disturb the general health, 
however severe or painful it may have been ; and it is often cured 
by medical treatment, by marriage, and by child-bearing, while it 
ceases at a certain period of life. Still, its cessation may be fol- 
lowed by certain organic diseases. 

Treatment. — To reheve the sufi'ering when present, and to pre- 
vent it during the intervals, are the objects we must aim' at, and it 
is very difScult to attain the first. Still, we may give relief in al- 
most all cases. 

If the patient is strong and full-blooded, leeches must be ap- 



408 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

plied, though many women do not like the idea of leeching, lest 
the discharge should, as they say, be driven away altogether ; but 
there will be no danger of this, if a few leeches be applied to the 
upper part of the thighs. They may give relief by lessening the 
inflammatory tendency that prevails. 

Fomentations with hot sponges, the warm bath, the warm hip 
bath, injections in the forepassage of wa.rm decoction of poppies, 
and hot fomentations over the front and lower part of the body ; 
and after them, a belladonna plaster. 

An opiate suppository or lavement (see Glossary) is most effi- 
cacious ; or else tincture of opium in a draught ; but if opium can 
not be borne, from peculiarity of constitution, give two of the fol- 
lowing pills every third or fourth hour : 

No. 185. Compound galbanum piU 30 grs. 

Extract of henbane 20 grs. 

Biborate of soda 30 grs. 

Extract of belladonna 4 grs. 

Mix well, so that the last ingredient be equally divided, and 
make twenty pills. 

The secretions should be attended to, by mild aperients occa- 
sionally ; warm or cold salt water baths, and whatever is useful in 
conducing to healthy vigor. 

The iodide of iron, the wine of iron with compound spirits of sul- 
phuric ether, the ammoniated tincture of guaiacum, the tincture of 
cantharides have all been recommended more or less strongly. 

But I have found the greatest advantage from giving the fol- 
lowing drops, about six or seven nights before the expected time, 
having previously taken care to correct whatever seemed to need 
correcting ; to remove indigestion, if that were present, or costive- 
ness, the latter not by sharp purgatives, but by gentle aperients. 

Drops against Painful Periods. 

No. 186. Wine of colchicum seeds |- oz 

Tincture of opium 1 oz. 

Of this, thirty, forty, or fifty drops have been taken every night 
at bedtime, for six or seven nights before each period, in some 
Water. A hip bath, also, for a like number of nights. 

These drops are serviceable also during the attacks, in doses of 
thirty drops, three or four times a day, with compound sulphuric 
ether, thirty drops, and an ounce of water. 



POLYPUS OF THE WOMB. ' 409 

Some who have once tried these drops, would never afterward 
be without them. The opium might tend to confine the bowels; 
then an occasional aperient becomes necessary. 

Polypus of the Womb. „ 

The term uterine polypus is employed to designate a class of 
tumors which grow from the inner surface of the womb, or from 
its neck or mouth, and which are attached to these parts by means 
of a neck of less size and diameter than the tumor itself. 

Womb-polypi are of a pear-like form, of a tapering, elongated 
shape in some instances, and round, or nearly so, in others. In 
size, they may be as small as a pea, or as large as a child's head ; 
their surface is generally smooth, the color variable, from that of 
paleness and straw color, to a color more or less bluish or purple ; 
they are vascular. We have said they are attached by one pedicle 
or neck, but two or even three attachments have been met with. 
Probably there is but one pedicle, and the other attachments oc- 
cur from inflammatory action having been in some way excited, and 
adhesion forming at one or more points. 

A polypus is entirely inclosed within the womb at first; but as 
it becomes larger, it dilates gradually the neck and mouth of the 
womb, passes through them, and protrudes into the passage called 
the vagina. 

The local symptoms attending these polypi are such as would 
arise from the presence and irritation of any foreign body in the 
passage. The mucous secretion of the part is increased, and be- 
comes purulent as well as mucous, after a time ; and the patient 
deems, perhaps, herself to be afi*ected with whites only. 

But the discharge may have some blood intermixed, or it may 
become discolored and fetid — so much so that many persons have 
been almost reduced to despair, because they thought ^'a cancer 
was forming," until an examination had been made. 

There is a feeling of weight and uneasiness in the part, with a 
frequent desire to make water ; or there is a bearing down in the 
back bowel. 

If the discharge is profuse, there are signs of debility or of ex- 
haustion; and severe indigestion, with vomiting, palpitation, and 
dropsy of ankles are present. 

The quantity of the discharge is not in proportion to the size of 



410 AMEPJCAN HOUSEHOLD BOOK OF- MEDICINE. 

tlie polypus, since a small one, situated in the neck of tlie womb, 
may cause as much as the largest of polypi. 

Fortunately, when these polypi are once removed, there is no 
tendency to a reproduction ; neither is there any danger in remov- 
ing them, if the case is properly selected. 

The bad effects they produce arise from the exhaustion of the 
discharge, and from the pressure which they, when very large, may 
exert on neighboring parts. 

Treatment. — While the polypus remains out of the surgeon's 
reach, we may do much good by throwing up injections, and by 
treating as we treat cases of whites or of profuse menstruation, 
so as to prevent the exhaustion which so often arises from the dis- 
charge. 

The tumor, which must be removed, may be taken away in three 
ways : If it is small, or of a cellular character, by forcibly twisting 
it off. Secondly, it may sometimes be drawn downward, and the 
pedicle divided by knife or scissors. And lastly, a ligature may 
be applied to it, so to constrict the pedicle as to cause it to fall off 
in time. 

The best mode is that of applying a ligature ; and the reasons 
why this mode of removing the polypus is preferable to either of 
the other two, it needs not that I should relate; but this opera- 
tion should generally be performed only when the pedicle is smaller 
than the body of the swelling, and its surface smooth, for a rough 
surface accompanies malignant disease. 

I was consulted, some years ago, by an infirmary patient whose 
emaciation, debility, and deep saffron-colored skin had been at- 
tracting great sympathy and attention. She was supposed to be 
dying from cancer of the womb. 

On examination I found an uterine polypus, so large as to nearly 
fill the vagina, with a neck of a diameter almost equal to that of 
the body of the polypus; while the nearest point, the head, felt 
rough to the finger. 

I^otwithstanding these suspicious circumstances, extirpation by 
ligature was recommended. 

The surgeon of a neighboring town, who had attended her all 
along, absolutely refused to operate, and persuaded the woman to 
refuse. He said it was a case of cauliflower excrescence ; that it 
was of malignant growth. 

After some discussion, it was agreed that the woman should seek 



CAULIFLOWER EXCRESCENCE OF THE WOMB. 411 

the advice of an eminent accouclier. She did so, and brought a 
letter to me to the effect that he would operate if the case were 
Tinder his care. The ligature was applied ; the polypus was brought 
or came away in eighteen or twenty-one days. The fetid, horrible- 
looking, discolored discharges were stopped, and the dying woman 
soon recovered all her original good health and bloom. 

On examining the polypus, its surface was found to be smooth; 
only some large vessels ran over the surface, which were dilated 
by the compression of the sides of the vagina, in consequence of 
the size of the polypus ; and the pedicle was thickened and swollen, 
probably from a similar cause. 

Cauliflower Excrescence of the Womb. 

An excrescence like a fungus sometimes grows from one lip, or 
from the whole circumference of the mouth of the womb, insen- 
sible, like the ordinary polypus we have just described, but having 
a broad base and an irregular surface, which has a tendency to 
bleed at times, and also to recur if it be removed. 

Symptoms. — Little or no pain ; an abundant secretion and dis- 
charge of fluid, and this discharge constitutes the distinguishing 
symptom. It is of a watery character, not of any smell, and often 
mixed up with the ordinary discharge of the whites, and also with 
more or less of blood. 

If the tumor be examined by a speculum, its color is a bright- 
red or flesh-color; and its size may vary from that of a hazel-nut 
to that which fills the vagina. When it begins to attract attention, 
it is often not bigger than a strawberry. 

The drain from the swelling goes on ; and, as there is no smell, 
the patient's attention is not a.ttracted to it until the constitution 
becomes quite exhausted. 

The stages of this exhaustion are marked in the usual manner — 
by languor, weakness, indigestion, etc., down to dropsical ankles 
and extreme exhaustion. 

Treatment. — We must check or prevent, if we can, the discharge, 
by the usual astringent injections, by a mild, unstimulating diet, 
recumbent position, avoidance of all local stimulus, and gentle lax- 
atives occasionally. The cold hip bath or douche to the loins ; 
and gentle bitter infusions, as of gentian or calumba with sal vola- 
tile, and some carbonate of soda — two ounces of infusion, twenty 



412 AMERICAN HOUSEHOLD BOOK OF MEDICINE, 

drops of sal volatile, and twenty grains of soda, two or three times 



a 

This tumor has been removed by ligature, but it has generally 
recurred ; and the only operation which promises any chance of 
success is excision, or cutting away of the swelling itself, and also 
of the neck of the womb. This has been done with success, and 
no recurrence of the malady. When the disease does recur, -an 
operation has prolonged life, by taking away, for a time, the source 
of the exhausting discharge. 

The CoRRODiNa Ulcer of the Womb. 

This is a variety of ulceration differing from cancer in not being 
attended with deposit of diseased structure around the affected part. 

There are no symptoms to be depended on, and the disease is 
only made out by a medical man's examination under whose care 
the patient should place herself. 

Colorless, or Transparent, or Watery Discharges from the 

Womb. 

The known sources of the watery discharge from the womb are 
two — the cauliflower excrescence, and hydatids situated within the 
cavity. 

Hydatids are unattached vesicles, possessing their proper vital- 
ity, and are dependent upon the parent body for the situations and 
conditions of existence. 

Hydatids have the appearance of soap-bubbles, with a limpid 
fluid in them instead of air, the envelope looking like a film of 
coagulated white of egg. They vary in size from that of a millet- 
seed to that of the largest orange ; they are of a globular or sphe- 
roidal form, and their specific gravity is nearly that of water, though 
they generally sink when plunged into this fluid. They are trans- 
parent and clear, though their envelopes may give them an opaline 
hue, in spots, or all over their surface. 

Within these hydatids globules may be seen floating about un- 
attached, in the interior of which other globules appear, successive 
generations thus appearing in the same cyst. 

They adhere to the neighboring parts, often causing inconve- 
nience by their pressure and presence ; they decay after a certain 
time, and the skins or empty bags are squeezed together. 



SPINAL CURVATURE. 413 

Hydatids are divided into the solitary and the prolific. The first 
is most common in animals ; the last, in man ; and these latter con- 
tain always numerous others within their cysts — from a hundred 
to a thousand may be contained in the same cyst. 

These parasites form without exciting any disturbance, and their 
existence has never been suspected until they were found ^after 
death. 

Treatment — There can be no treatment where there are no symp- 
toms ; but in the present case of hydatids in the womb, there may 
be a colorless discharge, like water indeed; and the patient must 
then try to have it ascertained whether this watery discharge pro- 
ceeds from a cauliflower excrescence or from hydatids. The only 
unerring sign of the latter is the cyst itself, swimming or floating 
in water when recently discharged. 

The remedies are whatever will tend to restore or augment the 
vigor and health of the patient — tonics, vegetable or mineral baths, 
good food, etc. ; for it is a received rule that parasites form, mul- 
tiply, and increase in proportion as the patient becomes weakened, 
and as the excretions or secretions accumulate or are retained. 

Spinal Curvature. 

This is perhaps one of the most frequent afi"ections we meet with. 

Spinal deformity may be produced in various w^ays ; there may 
be disease of the bodies of the bones of the back, and of other ad- 
jacent parts, from scrofula. With such forms we do not here med- 
dle, but we allude to w^hat is called lateral curvature. 

At first there would seem to be nothing but muscular weakness ; 
and the first sign of the future deformity, if neglected, is a rising 
of one shoulder higher than the other, and a greater fullness. On 
examining the spine, we shall find a curve to right or left in those 
spinal bones which are between the shoulder-blades. This state 
may last for some time ; but the same causes continuing to operate, 
another curve takes place lower down in the loins, forming a figure 
like the letter S ; and this is called the double curvature. 

The upper lateral curvature has generally its convexity to the 
left, and comprises the lower neck spine-bones and two or three 
of the upper back ones. 

The middle curvature generally has its convexity to the right, 
and it is formed by the spinal bones of the back. 



414 AMERICAN HOUSEHOLD BOOK OF MEDICINE, 

The lower curvature has its convexity to the left, and comprises 
the lumbar and lowest spinal bones of the back. 

The consequences of lateral curvature are usually very slight; 
but when the curvature is extreme, it often gives rise to very serious 
symptoms — -severe pains, cramps, and numbness — in consequence 
of pressure being exercised on the nerves, which issue from the 
spinal marrow ; and the>. deformity may increase to such a degree 
as to impede the due action of the heart, lungs, stomach, etc. 

This disorder attacks from the age of eight to eighteen. A pre- 
disposing cause is the female sex; a rickety, scrofulous constitu- 
tion also disposes, and so does impure air and whatever is calcu- 
lated to induce debility. Very slight exciting causes will bring on 
this affection. The attitude necessary to carry a child in arms is 
a prolific source ; and we too often see a little bit of a girl, not 
long able to walk alone, carrying a baby on her arms. Standing 
on one leg, and a certain position when learning writing, drawing, 
etc., are also causes. But of all causes, stays are the monster 
cause, and annually send many to their graves, who, but for them, 
might have lived many years, in enjoyment of a happy life. " These 
abominations are made so as to press downward and together the 
lower ribs ; to reduce the cavity of the chest, especially at its base; 
and even partially to displace these vital organs. They leave the 
upper regions of the chest exposed ; those very regions where tu- 
bercular, consumptive, bronchial, and inflammatory diseases gen- 
erally commence, and which are the most prone to attack, from the 
vicissitudes of the season, weather, temperature, humidity, and ex- 
ternal injury. These noxious and unnecessary articles of clothing, 
these mischievous appliances to the female form, useful only to con- 
ceal defects, are rendered still more injurious by the number of 
unyielding or only partially yielding supports with which they are 
constructed on every side. There are the whalebones in the back 
and sides, and the steel in front, extending nearly from the top of 
the sternum (breast-bone) almost to the pubes (lowest part of front 
of body)." The author goes on to remark on the effects caused 
by the pressure on the vital and assimilative organs, and then ad- 
verts to this metal support. " However well it may be protected 
from contact with the surface, it acts as a conductor, both of ani- 
mal warmth and of the electro-motive agency passing through the 
frame ; it carries off, by its polarization, into the surrounding air, 
especially during humid states of the atmosphere, the electricity 



SPINAL CURVATURE. 415 

of the body, this agent being necessary to the due discharge of the 
nervous functions, either in its electro-galvanic state or manifesta- 
tion." 

Now, without attaching too much importance to the electro-gal- 
vanic objection (for some young ladies do not wear metallic fronts), 
there is no doubt that the tight stays do compress and prevent tjie 
due action of muscles, whereby they lose their powers, and ulti- 
mately dwindle away. I knew of a case of a Mademoiselle Le- 
blanc, a young French milliner, remarkable for the petitesse of 
her taille, who died an early victim of consumption ; and it was 
found that those portions of the muscles of the loins and fore-stom- 
ach, which had been subjected to the highly-strained pressure of 
the corset during life, were reduced to the consistence of a soft 
and flaccid cellular tissue, faintly sheeted with muscular fibers. 

If the spinal deformity be suffered to continue unchecked, the 
lungs do not expand sufficiently ; difficulty of breathing, debility 
of the stomach functions, heart disease, and dropsy of the chest 
may ensue in the end, from the continued pressure — a pressure 
which is sometimes never intermitted ; for some of the victims can 
hardly sleep but w^ith their stays on them. 

Treatment. — Attention should be immediately paid to the slight- 
est derangement in the symmetry of the spine and shoulders ; for 
the early treatment is uniformly successful. 

All habits must be investigated ; the mind must be less attended 
to, the body more ; and instead of inciting a perhaps clever daughter 
to too much study, the hours of schooling should be shortened. 
Exercise in pure air, and plenty of it, yet so as never to fatigue, 
must be enjoined. If appetite be deficient, gentle tonics must be 
given ; neither should the parents or teachers insist too much on 
the Cooper chair and the sit-upright system ; for, since some can 
bear the erect position longer than others, those who feel fatigue 
from sitting or standing too long in the perpendicular, should be 
suffered to rest the fatigued muscles by a recumbent position for a 
time. All the talk about marvelous couches should be rejected 
as unworthy of credit, and the main point as to beds or couches is, 
that they should not be heating to the back, as a feather-bed for 
instance. 

As to the Cooper chair, I think that no contrivance could have 
been invented better adapted to increase the deformity. It is 
astonishing how soon, in so inconvenient a seat as that forms, the 



416 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

girl slides into a position by which the muscles relieve themselves, 
while some are acting, and others, which should act at the same 
time, remain quiescent. There is no trustworthy evidence that 
Sir Astley Cooper ever recommended or invented that chair, and 
the fiction may be classed with that of the Abernethy biscuit. 

But possibly the disorder has made some progress, and effective 
treatment must be attempted. Here a fertile field has been opened 
to quacks and speciality doctors. 

Many years ago, I recollect the system recommended by Drs. 
Bell and Shaw ; and some sufferers used to be told that they were 
to keep the recumbent position night and day, for one, two years, 
or even longer, and they would at the end rise up straight. 

And so they did, but the muscles so long inactive, could no 
longer maintain the erect position, and soon the old deformity made 
its appearance. But, in addition, it was found that, in many in- 
stances, where there was a predisposition, consumption was also 
set up. 

Whatever is done remedially must be done while the girl con- 
tinues her usual daily avocations, and this has been effected by 
only one gentleman, Mr. Joseph Amesbury. His practice is, to 
order daily practice on an inclined plane, made in such a way as 
to allow of the general action of the muscles affected, while for the 
deformity itself he has invented what he calls a spinal support, 
which is so arranged as to gently press back the protruding parts, 
and to allow for the filling up of the corresponding hollow. And 
after curative treatment was ended, he recommended stays, called 
simple supports, to prevent a recurrence of the deformity. 

The patients continue to walk about as usual, and the general 
health not only does not suffer, but is much improved. 

This is the only mode of treatment, combined with general at- 
tention to the health, which I can recommend ; and of the advan- 
tages of this I have been an eye-witness. Where the disorder 
has not gone so far as to allow of the spinal bones being immova- 
bly fixed in their unnatural positions, I have seen great deformity 
from the double curvature repeatedly remedied, and health restored. 

As to deformity from disease of the bones, caused by scrofulous 
or other morbid action, each case must be treated as recommended 

in SCEOFULA. 



SPINAL IRRITATION. 417 



Spinal Irritation. 

The general description of tliis is pain in some part of the spinal 
column, generally accompanied by neuralgic or hysterical affec- 
tions, unattended by fever, or by other indications of inflammation, 
injury, or structural change of the spinal column, or of its contents. 

These words of Dr. Copland very correctly and graphically de- 
scribe spinal irritation : 

"A diversity of symptoms attend this state, varying in a con- 
siderable degree, according to the part of the spine affected. 
When the pain or tenderness is felt in the dorsal or back portion, 
it is sometimes referred to one side of the column, generally to the 
left side, and is often felt beneath the left mamma or breast ; more 
rarely it is felt on the right side. In these cases, there are hys- 
terical symptoms, with a feeling of tightness in the chest, or of 
suffocation even, with difficulty of breathing, being obhged to sit 
up erect always, with palpitations or spasmodic cough. 

^'When the lumbar spine or loin part is affected, there will be 
pains and tightness in the abdomen or belly ; numbness, cramps, 
pains, great tenderness, and, in some cases, even palsy of the lower 
limbs are added ; constipation, retention of the urine, or else irri- 
tability lower down in the abdomen, with frequent desire to make 
water, or bearing down, as if of the womb, and the periods dis- 
turbed or very painful, will attend irritability of this portion of 
the spine. 

" Irritation in the neck portion is not so often met with as the 
two former states. Here the pain may rise and extend to the back 
of the head. There will be pains in face or neck, noise in the 
ears or deafness ; difficulty of swallowing ; a choking feeling ; loss 
Qf voice and speech ; an attack like croup ; sense of suffocation ; 
an approach to debility or palsy of the arms, with pricking sen- 
sations in the hands ; and coldness or numbness of one or both 
hands." 

With these symptoms, we shall find, on examining each bone in 
the spine — by tapping some particular one with the knuckles, and 
sometimes by putting a sponge wrung out of warm water — that 
pain or tenderness is felt there and nowhere else along the spine. 
Percussion seldom fails to elicit the pain. 

Spinal irritation may be of a gouty, a rheumatic, or a syphilitic 
nature. 

27 



418 AMERICAN HOUSEHOLD BOOK OF JMEDICINE. 

Treatment — If the person be full-blooded, it will be well to 
lower a little at first, by cupping or leeches. 

Dry cupping is often very useful. It is effected easily by throw- 
ing a very small bit of paper, touched with ether or with turpen- 
tine, and lighted, into a cupping-glass. This acts powerfully ; and 
the glass or tumbler has been half filled with muscle or integu- 
ment, such was the powerful exhaustion. In this way no blood is 
taken away, and so we may safely dry-cup where there is debility. 

Blisters or irritant embrocations, such as the tartar emetic oint- 
ment : 

No. 187. Tartar emetic J oz. — 120 grs. 

Lard 1 oz. 

Or, if this fail to bring out pustular eruptions, then add sugar, 

thus : 

No. 188. Tartar emetic 2 drachms. 

White sugar 1 drachm. 

Lard 9 drachms. 

Mix. 

Let the crop of pustules remain for two or three weeks ; if they 
are too annoying, poultice. 

We should correct whatever seems to want correcting in the 
system. If piles have been suppressed, or the periods, leeches to 
the perineum, or near the anus. 

The urine should be examined, and treated according to its 
state, if it is out of order. The liver may not be acting properly; 
then some blue pill, aperients, etc. ; gentle tonics. 

But our reliance must be placed chiefly on cupping, blisters, 
and irritating embrocations. 

Hysterics — Hysteeia. 

What is called regular hysteria is distinguished by its marked 
paroxysmal character ; that is to say, there may not be any symp- 
toms of habitual disorder ; but the patient is liable, under the in- 
fluence of slight exciting causes — physical or mental, and, at other 
times, without any decided cause of the kind, or seemingly of any 
kind — to sudden attacks 'of a spasmodic nature. 

The patient, perhaps, may feel uneasy ; then a feeling of stiff- 
ness about the throat arises ; then the patient stares about, and 
seems queer in her manner ; then a ball is felt rising in the throat, 



HYSTERICS— HYSTERIA. 419 

and this ball is so rarely absent, if ever, that it is called globus 
hystericus, or the hysterical ball ; then follow laughter, weeping, 
and much nervous agitation. 

Thus terminates a mild fit of this singular disorder. In more 
severe seizures, the agitation of mind and body is very great; 
there are oppression at the chest, difficulty of breathing, palpita- 
tion, and speechlessness. The sufi'erer falls down ; the breathing 
is slow, and the belly is much distended with wind ; a quantity of 
limpid, colorless urine is passed ; the patient seems to have lost 
her senses, and may become violent. The limbs may be either 
motionless or convulsed, and, in some cases, she rests on the back 
of her head and her heels. After a time, the convulsive motions 
become less and less violent ; a quantity of wind comes suddenly 
from the stomach ; and soon afterward, with sobbing or laughing, 
the sufferer comes to herself — sometimes retaining a recollection 
of what had passed, sometimes not. 

The fit may last for several hours, and may pass into a state 
of coma (unnatural sleep), or into a state of syncope (fainting), 
peculiar in its character, and sometimes so closely resembling 
death as to have led to mistakes. 

The severe attacks may be over in a quarter of an hour or less, 
or they may last many hours, or even several days; and they 
chiefly occur when the periods are suspended, or when the diges- 
tion or bowels are deranged ; in short, whenever any cause of irri- 
tation exists anywhere in the body. 

Between the attacks it is not difficult to see who is likely to be 
exposed to them ; the nervous balance is easily excited and easily 
overthrown. 

When the disease has lasted a long time — for years — unchecked, 
the nervous system becomes seriously affected, and palsy, impaired 
memory, or even mania, may ensue. 

This is what may be called regular hysteria ; but the irregular 
form, where there is no regular fit or paroxysms, who can ade- 
quately describe ? The states and symptoms are so varying, and 
so many diseases are simulated in this state, that it requires much 
watching and practical tact to avoid error. 

Irregular hysteria may exist without any paroxysms or fits at- 
tacking the patient ; the symptoms are very various, and the dis- 
order has justly been called the pathological proteus. Few com- 
plaints are more likely to baffle the junior practitioner than this; 



420 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

it simulates, and sometimes closely too, many disorders of a se- 
rious and organic nature. Many sufferers have been bled, cupped, 
and blistered, not only without relief, but with addition to the 
original cause of the mischief. 

Hysteria aifects chiefly young women, in whom the process of 
menstruation is in some way disordered, whose constitutional pow- 
ers are feeble, either naturally so, or from exhaustion and debility 
caused by disease or habits of life. Their complexions are pale ; 
hands and feet obstinately cold ; their appetite is much impaired, 
and, in many cases, vitiated, in which latter case the most singular 
articles are fancied and eaten ; chalky substances are favorites ; 
candles, wafers, sealing-wax, slate-pencil, and various other indi- 
gestible matters, are sought after ; yet no flesh is lost, no progress- 
ive emaciation is to be observed. 

It will be interesting to follow Dr. Watson's description of some 
of the organic disorders which are closely simulated in hysteria. 
One not uncommoji instance is that very serious disease called 
inflammation of the peritonaeum (membrane lining of the bowels). 
Suddenly there will be acute pain in the belly, increased by the 
shghtest pressure ; the skin will perhaps be hot, pulse quick, and 
tongue furred. Now, if a state of inflammation really existed in 
this part, the treatment ought to be vigorous — ^by. blood-letting, to 
great extent, by mercurials and lowering means ; therefore, before 
such exhausting treatment is determined upon, it should be ascer- 
tained whether the periods have been wrong in any way, and 
whether there have been any previous attacks of hysteric fits, or 
the pain is augmented by increase of pressure ; for continued and 
firm pressure will augment the pain in inflammation ; not so in hys- 
teria; or whether it seems seated in the skin, and is excited by the 
slightest touch. I am in the habit of engaging the attention of 
the patient by asking questions, etc., while I am pressing, at first, 
gently on the part. The pressure is then hardly noticed in hys- 
teria ; not so in inflammation. If so, do not bleed, but throw up 
an assafetida injection, and, in a short time, the symptoms of peri- 
tonitis will have disappeared. 

Dropsy of the belly has been imitated by a flatulent distension 
of the bowels, to such an extent as to cause the patient, if im- 
mersed, to float on water. This flatulence may possibly proceed 
from a paralytic debility of the bowel muscles, or from a secre- 
tion of gas. This gas has been analyzed, and found to consist of 



HYSTERICS— HYSTERIA. 421 

carbonic acid gas, some nitrogen, hydrogen, and carburetted hy- 
drogen. We may satisfy ourselves that there is no dropsy by 
tapping or percussing the belly with our fingers, when a clear and 
not a dull sound is returned. 

Then we have the very common and intractable pains in the left 
side, which so many females complain of, and which give great alarm 
to many minds, because they fancy something serious is gathering 
there. Beware that the strength is not lowered by leeching, blis- 
tering, purging, etc. 

There is also an hysterical pain in the head and over the brow; 
this latter has been called brow-ague, the former clavus hystericus, 
and they were alluded to in the article Headache. 

Palsy, again, has been simulated, but the palsy comes on very 
suddenly; the person may be known to be hysterical, or a fit of 
hysteria will declare what the real state is. 

Total loss of voice is another instance, and inflammation of the 
upper part of the air-pipe and croup are both mimicked. The 
patient will breathe with the noise peculiar to croup ; and in one 
case, the operation of opening the windpipe by an instrument 
had been twice performed, the scars of which operations remained 
visible. 

Inability to swallow is very common, and the suiferers are firmly 
persuaded that their gullets are mechanically closed, and will in- 
sist on an instrument, called a probang, being passed down. In 
one case, the moment the probang was introduced, a sharp fit of 
hysterics occurred, followed by similar fits in other females, who 
were present at the time. 

The hysterical breast, again, is not uncommon ; it becomes pain- 
ful, tender, and enlarges somewhat. Ideas of cancer immediately 
arise ; now, if these symptoms are not treated with leeches, and 
fomentations, etc., and if the local afi'ection is made very light of, 
the irritability and pain will soon subside. 

Cough is common. Hysterical cough is hard, loud, and soHtary, 
producing hurried breathing, palpitation, and perspiration; and the 
cough is sometimes attended with a sort of howl, like that of a dog. 
At other times, the coughing is rapid, short, and tearing. 

Hiccup is very distressing ; in one case, the hiccup, loud and 
discordant, occurred every eight or ten seconds. 

Another person, a servant, could not get any place, on account of 
a continual hysterical eructation, which distressed her continually. 



422 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Vomiting of blood is not uncommon. One girl used to vomit, 
daily, potfuls of dark blood (which did not coagulate) ; yet she did 
not lose flesh, and she went through her periods of menstruation 
quite regularly, only during the periods no blood was vomited; 
she did not receive any benefit from medicines, but after some time 
married, and recovered. 

Coughing of a fluid looking like blood is met with in hysteria. 

Diseases of the joints are closely mimicked by this singular dis- 
order, and so closely as to puzzle exceedingly. Four-fifths of the 
female patients in the higher ranks of society, who are commonly 
supposed to labor under diseases of the joints, labor under hys- 
teria, and nothing else. 

The knee and hip are usually the chosen sites and joints. One 
lady, unmarried, had sufi'ered so long and so much from pain in the 
knee, that she peremptorily and urgently demanded to have her leg 
cut off", and the attending physician was obliged to temporize; yet 
it was all hysteria. 

Spinal disease is closely imitated ; pain and tenderness in the 
back-bone, with weakness in the legs, are the symptoms ; and 
many a young female has been made to maintain the recumbent 
position for years even, and have had issues repeatedly made, 
etc., who labored under hysteria, and needed nothing of the kind, 
but a totally different mode of treatment. Some fancy they can 
not empty their bladder ; others that they labor under stone in the 
bladder; others will declare that they are unable to move, and ap- 
pear to suffer great tortures if an attempt be made to move them ; 
yet no real inability exists, save in the fancy. This disorder is 
named after its supposed origin in or connection with the womb, 
and the term hysteria can not well be applied to males ; still, that 
peculiar modification of the nervous system which is observed in 
hysteric girls is occasionally, though rarely, to be met with in 
males. 

There is one disease, the paroxysms in which may be mistaken 
for those of hysteria — it is epilepsy ; and there is another which it 
may resemble, when in its chronic and not acute form — hypochon- 
driasis ; but, under all circumstances, we must closely observe, 
and we shall seldom fail to perceive the variety, changeableness, 
and incongruity of the symptoms in hysteria, the irregularity of 
their course, and the rapid alterations of violent derangement, and 
of a nearly natural state, with which they are attended. 



HYSTERICS -HYSTERIA. 423 

The genuine epileptic fit attacks suddenly witli a slirill cry; the 
eyeballs are distorted, teeth ground against each other, pupils of 
the eyes dilated ; the tongue protruded from the mouth ; the face 
swollen, discolored, and the larynx or air-pipe is closed spasmod- 
ically. The fit is followed by heavy sleep, and nothing is remem- 
bered on awaking of what passed during the fit ; and, after ipany 
attacks, the countenance becomes inexpressive, heavy, imbecile, or 
idiotic. The hysterical paroxysm is attended with laughing, cry- 
ing, and a feeling of the hysterical ball ; the muscles of the face 
and the pupils of the eyes remain nearly in their natural state ; 
but there is a peculiar trembling of the eyelid, which is a sign of 
great value ; and wherever it is present, no matter whether the 
attack be called hysteric, cataleptic, trance, or mesmeric slumber, 
it is a sign of safety, and strongly suggestive of the cold efi'usion ; 
the respiration is of a sighing, heaving character, and after the 
fit there is more or less recollection of what has passed; nor does 
sleep follow, though the patient remains tranquil. But the two 
may be mixed up together. 

Hypochondriasis may be supposed to exist when there is hys- 
teria, but they are sometimes intermixed; however, distinctive char- 
acters enough do exist. In the former there is a false direction 
of the moral energy, with inactivity, a concentration of all interest 
upon self alone, and a disposition to have recourse to a great many 
medical advisers. Hysteria is accompanied with a fitful activity 
and a lively interest in the welfare of others, with confidence in 
the (one) medical attendant. Hypochondriasis is marked by sul- 
len countenance, gloomy ideas, dejected spirits; hysteria by a rest- 
less, animated expression, convulsive paroxysms, fickle temper. 

Causes — predisposing are, the female sex, celibacy, the period 
of life comprised between puberty and the fifty -fifth year, a studi- 
ous and sedentary life, want of good air and exercise, grief and 
anxiety, impaired health, fullness of blood, the scrofulous tendency. 

Exciting causes are, indigestion, confined bowels, flatulence, any 
cause of exhaustion, suppression of the periods, fullness of blood, 
violent mental emotions, imitation or sympathy, tight lacing. 

Hysteria, uncomplicated with epilepsy, is seldom attended with, 
danger in females ; but in males it may end in mental unsoundness.. 

One marked difference between hysteria and organic disease, if 
the disorder has continued long, is that, however long the suspi- 
cious symptoms may have lasted, there is no correspondent wasting 



424 AMERICAN HOUSEHOLD BOOK OF .MEDICINE. 

away, or no commensurate impairment of the general health, which 
there ivould be if organic disease had prevailed so long. 

Treatment. — Treatment is divided into that during the fit, and 
that between the paroxysms to prevent their recurrence. 

First, during the fit, loosen the dress. Prevent the patient from 
doing herself any injury during her struggles. To put an end to 
the fit, cool air, and if the patient can swallow, give four table- 
spoonfuls of the assafetida mixture : 

Assafetida Mixture. 

No. 189. Assafetida 2 dr. 

Water 1 pint. 

Rub together by degrees ; or, 30 drops of ether, with 15 or 20 
drops of tincture of opium in camphor mixture ; or, a drachm of 
ammoniated tincture of valerian will answer. 

When she can not swallow, apply stimulating vapors to the nos- 
trils, smelling salts, etc. At the same time we should administer 
an injection, made by mixing two drachms of assafetida in half a 
pint of water, by gradually rubbing the assafetida and the yolk 
of an egg together, or, instead of the egg, an ounce of soft soap. 
Another useful inj ection is the turpentine injection. Half an ounce 
of turpentine is mixed with water in the same way as the assafetida. 

Or, half a pint of ice-cold water thrown into the back passage, 
or applied in front of the lower part of the body. 

Cold water should be freely dashed over forehead, face, neck, 
and chest; and this effusion of cold water, more or less forcible, 
is often of great service, not only in shortening the fit, but some- 
times in preventing it. 

The following remarks are so true, and have been so often veri- 
fied in my practice, that I can not refrain from making an extract 
from Dr. Watson's Lectures : 

"In those long paroxysms — if they may be so called — in which 
some other disease is simulated by hysteria, the cold efi'usion is a 
most valuable resource, especially in those forms of the disorder 
in which a limb is permanently bent or incapable of motion. In 
several instances in which such contractioji had existed for a long 
time, it has yielded to the cold douche. Dr. Corfe, as I stated 
before, takes much pains with these cases. He pours cold water 
from a tea-kettle, or any other convenient vessel, in a small stream, 
from a moderate height, upon the contracted limb. It has been 



HYSTERICS— HYSTERIA. 425 

Tbent up for weeks, perhaps; no power that you are able to exert 
can -extend it, and any very forcible attempts to straighten it give 
the patient extreme pain. After the stream of water has been kept 
up for a short time, the patient complains of it very much ; but 
Dr. Corfe is inflexible — more so than the culprit limb ; he goes on. 
Presently the limb begins to tremble, the tight state of the musTsles 
is evidently on the point of yielding, and in no long time they are 
entirely relaxed and manageable, and the limb becomes as man- 
ageable as ever. It often happens that the state of contraction 
recurs ; but a repetition of the douche has always the same good 
effect, and by degrees the habit is broken, and the patient set free. 
It requires some determination to put this expedient in practice. 
The patient looks upon you as a monster of cruelty, and in pri- 
vate, the friends will not always allow such rough treatment, as 
they consider it. Dr. Charles Clarke, who saw a great number 
of these cases, which are more common in the upper than in the 
lower classes of society, is a great advocate of this ducking sys- 
tem. He recommends a 'sudden and lavish' application of water 
to the face, or the immersion of the whole body. He describes the 
class of patients in whom the hysterical affection which is curable 
by that method occurs, as being generally females of a pasty com- 
plexion, fat, pale, and weak, or such as evince the ordinary signs 
of debility, a feeble pulse, cold extremities, and purpleness of the 
parts distant from the center of circulation. The age of the patients 
varied from ten to thirty years. In many of them the 'periodical 
discharges were imperfect or absent.' " 

A case of trismus (locked jaw) is also related by the same physi- 
cian : "A young lady for many days had been unable to open her 
jaws, and, therefore, she could neither speak nor eat. At last Dr. 
Clarke was called in to see her. He presently comprehended the 
nature of her ailment, had her placed with her head hanging over 
a tub by the side of the bed, and proceeded to pour pitchers of 
water on her face. Before he had emptied the second the patient 
began to scream and complain, giving very audible indications that 
she could open her mouth. 'I say, although these patients get 
great relief by the treatment, they do not like it ; and if convinced 
it will be put in force, will generally contrive not to require it.' " 

The author, when physician to an infirmary, in one of the wards 
of which hysterical seizures from moral contagion, or from a prin- 
ciple of imitation, happened to be very frequent, soon stopped 



426 AMERICAN HOUSEHOLD BOOK OF MEDiniNE. 

every attack by employing the sluicing of cold water, and having a 
large vessel full of it ready for the nurses to use on the slightest 
indication of a seizure. The actual application of water was not 
needed after the first time. 

Many ladies of firm intellect, and of some energy of character, 
can conquer and have conquered the hysterical seizures, and the 
tendency to them, by moral efi*ort alone. Of this I have witnessed 
several gratifying instances ; while, on the other hand, I am sorry 
to say that I have lost the patronage of several of my patients, 
whom I had, as in duty bound, advised to exert this power of 
repressing hysterical tendencies. I told them what they might 
achieve, if they chose only to try. They preferred an useless sym- 
pathy, and the employment of all the numerous remedies given on 
similar occasions. 

During the intervals our efforts must be exerted to regulate all 
the secretions, and to impart as much vigor and tone as possible to 
the system. How this is to be done need not be detailed to those 
who have read the preceding pages. 

But, as in hysteria, the disorder consists in a peculiar state of 
the nervous center, which may produce the symptoms either spon- 
taneously under ordinary influences, or by irritation communicated 
from other organs. It may be divided into the idiopathic or sym- 
pathetic, for the convenience of considering the treatment. In the 
idiopathic we may have no evidence of disease anywhere but in the 
nervous matter of the head and spine, and we are, therefore, left 
to treat it according as it may afi'ect the circulation. 

Now, the circulation has, by Dr. Thompson, been supposed to be 
in one of two states — a state of congestion and the atonic state. 
The state of congestion generally manifests its attacks in the form 
called regular hysteria, occurring mostly just before the expected 
period. The convulsions are severe, the face flushed, the arteries 
of the neck and head are pulsating violently, and a fatal coma has 
followed in some cases. 

It is in this state that blood-letting is not only safe, but neces- 
sary ; cupping, leeches, or even the lancet may be employed ; the 
volatile tincture of valerian; no brandy; cold to head; a sharp 
purgative or two, and injections. Late hours, hot rooms, feather- 
beds are prejudicial. 

Sometimes little blood-letting will be necessary, if the patient 
will bear a sufficiently reduced diet. 



HYSTERICS— HYSTEHIA. 427 

Local congestion, wherever situated, must be met by local means. 
If there is headache, flushed face, and delirium, or some form of 
insanity, or the person lie unconscious of those around her, cup- 
ping to the nape of the neck, or a drachm of turpentine, rubbed 
together with mucilage, with thirty drops of tincture of capsicum, 
thrice a day, may be given. Aperients and aloes are neces'feary 
often. 

When the spine is observed to be puffy or tender, and the symp- 
toms before related are discernible, a few leeches to the tender 
part ; blisters or the tartar emetic ointment ; a blister on each 
side of the spine. A case of vomiting (seemingly hysterical), of 
two years' standing, was thus cured ; and palpitations, teasing 
cough, may thus be relieved. Ether may also be given; so may 
mercury, to a slight extent. 

When there is a spasm and closure of the organ of voice, cold 
water to the face, and salts to the nostrils. We should tickle the 
throat and swallow, with a feather. 

Firm closure of the jaws is overcome often by compression of 
the muscles between the chin and bone in the throat, or of the 
projecting cartilage in the throat. 

A drum -like, belly requires turpentine, or alum in considerable 
doses, while the lower spine is rubbed with stimulating embroca- 
tions. 

Mercury is usually prejudicial, if given beyond occasional doses ; 
but it is useful in the case of the obstinate barkino; cough which 
has been described. 

The atonic variety is attended with less vascular disturbance, re- 
quiring less depletion, and more tonic or strengthening treatment. 

Sympathetic or secondary hysteria is dependent, generally, 
either on derangement of the womb or of the bowels. 

In the latter case, there may be torpor or irritation in the bow- 
els. Irritation is marked by local symptoms — distended and ten- 
der belly, pain after eating, tongue with red papillae or points on 
it, thirst, etc., with more or less hysterical signs, or history of pre- 
ceding attacks of hysteria. 

Leeches, cooling saline medicines, with prussic acid ; twenty or 
thirty drops of sweet spirits of niter may be added to each draught, 
if the urine appear muddy. 

If the periods are, as often happens, too profuse, rest, liquor of 
acetate of ammonia. For an aperient, castor-oil. 



428 AMEMCAN HOUSEHOLD BOOK OF MEDICINE. 

For palpitation and flatulent colic, the assafetida injection. The 
diet must be regulated, stimulants avoided. 

The torpor of the bowels requires a stimulating aperient ; gal- 
vanism often helps. 

Uterine hysteria is attended with the periods too profuse, or too 
scanty; or there may be a white discharge. The mode of treat- 
ing these respective varieties may be deduced from the treatment 
laid down in the previous pages, for each separate state. 

For the pain in the side — which is neuralgic, and which is seated 
between the cartilages of the fifth, sixth, and seventh ribs — the 
tartar emetic ointment rubbed into the corresponding part of the 
spine, has been strongly recommended; leeches may be applied; 
also a warm flannel, dipped in warmed spirits of turpentine. 

For hysterical afi'ections of the joints, no bhstering, but bella- 
donna plaster, or embrocation ; a tepid lotion of spirits of rose- 
mary and camphor mixture, or a cold spirit lotion. If the pain 
and other joint symptoms intermit, the sulphate of quinine. Mar- 
riage is to be recommended or not, according to the existing state; 
exercise, country air, with amusing or useful employment. Ex- 
cessive sympathy should be avoided ; yet kindness tempered with 
firmness should be observed toward all hysterical piersons. 

Sterility, or Barrenness. 

Female unfruitfulness is a great grievance to almost every fe- 
male. It often depends on causes which can not be removed ; but 
then, at other times, the obstruction can be obviated. Those cases 
which depend on diseases of the ovaria (inward parts near the 
womb) can not be discriminated from others. 

Sometimes the membrane called the hymen is imperforate ; that 
is, has no aperture in it, which it should have, and it resists firmly 
all ordinary pressure to break it through. It becomes necessary 
to divide the membrane by means of a knife, which is soon done, 
and has been done by the sufi*erers themselves, though such an 
operation should never be attempted by any other person than a 
professionally-educated one. Usually this state of the hymen will 
have been discovered before marriage; for, with an imperforate 
hymen, the periodical discharge could not come away. Where 
the hymen is not altogether imperforate, the hole may be enlarged 
by a bit of sponge or of lint, rolled into the form of a bougie, and 



STERILITY, OR BARRENNESS. 429 

then dipped in a composition, made of one-third white wax and 
two-thirds of lard. This is smooth and stiif enough, and yet not 
too stiff to hurt the parts. It should at first be half an inch in 
diameter, which may be gradually increased to an inch or an inch 
and a half. It should be introduced every evening, and allowed 
to remain two or three hours, or as long as it can be borne. , 

In the barrenness which is accompanied with signs of want of 
power in the system, the atonic kind, nutritious diet, and all kinds 
of strengthening measures must be adopted. Generally we find 
that those have the most children whose diet is far from being so 
luxurious, or even nutritious, as that of the upper classes. Scanty 
and innutritions fare does not prevent offspring. 

A spare diet of milk and vegetables has been enjoined on a 
married couple, full-bodied and full-blooded, and desirous of chil- 
i dren, with great success. Active exercise in the open air must be 
conjoined. 

Generally speaking, a nutritious diet ought to be the best. Some 
articles of diet seem to possess an exciting power over the gener- 
ative functions, and not through the imagination either ; thus, 
hempseed and buckwheat have this influence on birds ; eggs and 
sweet milk on horses ; oysters, especially at spawning time, fresh 
eggs, pigeons, lobsters have been prescribed in cases of sterility. 

Climate has a great influence with respect to fecundation. A 
humid warmth of climate seems best to suit, not so much as a 
means of long life, but as a condition of its easy and rapid produc- 
tion. 

Extremes of heat and cold, dryness and humidity, are not fa- 
vorable. 

Removal into a warm climate from a cold one will often induce 
a tendency to conception. 

Sterility is probably seldom caused by disease of the ovaria ; 
for if one ovarium is diseased, the other will sufiice for impregna- 
tion. One lady's body was examined after death, and there was 
only one ovarium on one side ; yet the lady had been the mother 
of eleven children, of both sexes, and on one occasion twins were 
born. 

Many a case of sterility or barrenness is removable or curable. 
Some change is often wrought in the constitution and generative 
system by time or change of residence or by medicines, in many 
of those cases where ofi'spring is vouchsafed, after many years of 



430 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

married life had passed by, without conception having once oc- 
curred. 

The physician is continually meeting with cases where children 
have been born, for the first time, eight, ten, twelve, and even more 
years, after marriage, and where the married couple had resigned 
themselves to the prospect of never having any children at all. 

Catherine de Medicis, Queen of Henry II of France, had been 
married ten years to him before she bore him any issue, and then 
a numerous family followed. Again, Anne of Austria was barren 
for twenty-two years, and afterward gave birth to Louis XIV. 

May we not hope that in these cases the obstacles to conception 
might have been removed long before, if a searching investigation 
had been instituted. That the opposing causes were removable, 
the result showed, and they probably are connected with disorders 
of menstruation ; in most cases there is either a profuse discharge 
or suppression, or a painful bearing down attack when the periods 
come on, which bearing down would cause the expulsion of the egg 
in its early stage of growth. 

Polypus of the womb may be an obstacle, though it has not al- 
ways been so ; still, it should be tied and brought away, if feasible. 
The menstruation should be corrected according to its state, by 
the means already pointed out. 

We should exhaust every possible and imaginable means to 
bring menstruation to its proper state. 

As to cases of abortion, we shall come to them at a future time ; 
the subject of sterility (female sterility) is here alone taken up. 

If all means are exhausted, without success, change of residence 
or of climate must be tried. 



Inflammation of the Womb, or ^Metritis. 

Symptoms. — Pain increased by pressure on the region of the womb 
externally, or within the passage, by the finger on the neck of the 
womb, which feels hot, swollen, and very painful on touching ; the 
pain extends down the thighs and to the loins ; there is a sense of 
weight and of bearing down ; a difficulty in making water, and an 
inclination to do so, often with a swelling of the belly, and a windy 
blowing up or distension of it. In some cases there are symptoms 
of hysteria. These symptoms are accompanied by fever, nausea, and 
vomiting. Slight delirium, impaired vision, and a tendency to coma, 



CHRONIC INFLAMMATION OF THE WOMB. 431 

witli extreme prostration, startings of tlie tendons, etc., at the last 
in fatal cases. 

Causes — predisposing, are those of inflammation generally ^ ex- 
citing, are suppression or diminution of the periodical discharge 
from cold, the use of two astringent injections, mental emotions, 
physical injuries, blows and falls, child-birth, and local' excitemeiit. 

Treatment. — The usual course to remove inflammation must here 
be adopted ; blood-letting, general and local, cupping, leeches, the 
calomel and antimony powders (see No. 40), with five grains of 
Dover's powder, thrice daily ; local fomentations, hip baths, gentle 
saline aperients, and mucilaginous drinks for the dysury (difficulty 
in making water) ; saline aperients are occasionally required, and 
injections of warm or cold water, as may be most agreeable. 

Chronic Inflammation of the Womb. 

This may arise without the acute having preceded ; but often 
follows if the latter have not been properly treated, and the symp- 
toms are various, afi"ecting the health very materially. 

Chronic inflammation causes ulceration, or suppuration, or the 
formation of membranes, or the enlargement and hardening of the 
substance of the womb. 

Ulcers are situated usually on one of the lips of the mouth of 
the womb, and can only be detected by the medical man. Matter, 
where it is formed, is known when, during the periods, matter or 
pus comes away, mixed with the secretion, and by the patient feel- 
ing an increase of the symptoms during the period. When mem- 
branes are formed, painful menstruation occurs, which has been 
treated of. 

The symptoms of local weight and pain, etc., have been men- 
tioned under the acute form, only the febrile symptoms are absent. 
The periods are sometimes suppressed. 

Treatment. — This may be gathered from what has been laid down 
for the acute ; but Dr. Simpson particularly advises scarification or 
leeches to the womb itself, by means of a tube of ivory or pewter, 
of ten or twelve lines diameter, which is to be introduced gently 
to the end of the passage ; into it from three to six leeches may 
be put, and they are pressed along with a wooden rod. This should 
be done every second or third day, and the bleeding encouraged 
by sitting over or in warm water. Dr. S. says it is surprising to 



432 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

see the good effects from this local bleeding, even in females who 
seem Aveak and ill able to bear it. Hardening of the womb, such 
as to give the idea of cancer, is thus effectually removed. 

As to bringing the leeches away, if any have not fixed, it is easy 
to do so, by throwing in a little common table salt dissolved in 
water. 

The tartar emetic ointment should be rubbed in, so as to bring 
out a pustular eruption on the lowermost p^rt of the back-bone. 

If there is much debility or exhaustion, gentle tonics and support. 

Ireitable Womb. 

This is a painful malady ; there is constant pain in the loins, and 
round the brim of the hip-bones. A few days before or after the 
period, fits of anguish come on ; in one instance the pain came 
midway between the periods. The constant uneasiness, with occa- 
sional increase, soon induces the sufferer to give way to the relief 
afforded by repose, and to stir rarely from the sofa. The general 
health is soon broken by the worrying pain, and want of fresh air 
and exercise; then languor, costiveness, and indigestion are added. 
If the opening or neck of the womb be touched with the finger, the 
pain is increased to a great degree. 

The young and middle-aged are liable, and those of nervous, 
excitable temperament. Undue exertion, violent jolting, or long 
standing during the period may excite this disorder. Astringent 
injections employed to cure whites, once caused an attack. 

This disorder differs from prolapse of the womb by the latter 
being always relieved during a recumbent position ; here the pain 
is only diminished, and it differs from painful or membranous men- 
struation by the pain being periodical in the latter, while it is con- 
stant in the irritable womb. 

The issue is, that all are usually much relieved, while many 
recover completely ; there is no danger to life, though time is re- 
quired for treatment. 

Treatment. — To subdue pain and sustain the general health are 
the objects. Repose must be enjoined for a time, but it should 
not be indulged in longer than is absolutely needful. 

A belladonna plaster to the back ; or an injection of extract of 
belladonna one drachm to warm water eight ounces, night and 
morning, or an injection of two to four grains to each ounce of dis- 



MANAGEMENT DURING PREGNANCY. 433 

tilled water ; or a pill containing one-third camphor and two-thirds 
of extract of henbane, three times a day ; or what I have found use- 
ful, twenty drops of tincture of opium and fifteen drops of the wine 
of the colchicum seeds. 

The hip bath or poppy-head fomentations, if they seem to relieve. 
Gentle, not strong, nor forcing aperients. 

Small doses of steel, a regulated diet ; but avoid low diet, con- 
stant supine posture, close confinement, and depletions of whatever 
kind. 

Management during Pregnancy. 

In no situation in life is it more important to know how to avoid 
errors in self-management than it is in pregnancy; and many a 
young female incurs much unnecessary risk of miscarriage from 
pure unintentional ignorance in her novel situation — an ignorance 
which her natural delicacy prevents her from dispelling, by caus- 
ing a repugnance to seek information from her medical adviser, or 
from those who are better informed. 

Miscarriage is not only important and likely to be very prejudi- 
cial by the immediate sufi*erings which may be undergone, but also 
by the habit of miscarriage which may be originated. From the 
moment of conception, the future mother's duties commence ; and 
the object of the present writing is to point out the errors which 
are often committed during this state. But, before proceeding 
further, I would counsel all mothers to dissuade their daughters 
from marriage, if those daughters are in very delicate health, or 
are threatened with consumption. 

During pregnancy, child-birth, and nursing, there must be a great 
strain on the natural powers and strength. If these are above 
or equal with the average proportion, the young mother passes 
through her trials with her health ultimately unimpaired, and even, 
if possible, improved ; not so with those of delicate and consump- 
tive habit; for, in them, the trial weakens their frame, the con- 
sumptive tendency is roused or brought forth into action, and after 
one or l^wo child-bearings, life is often cut ofi* prematurely. 

Diet is the first subject upon which we must caution our readers. 
It is fancied that an extra proportion of food is necessary for the 
support of the child ; this is a very common and, at first sight, a 
not unreasonable error. 

Yet nature does not encourage this notion; on the contrary, a 
28 



434 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

reduction in the quantity of aliment would seem to be intended by 
her, else wherefore the morning sickness ? Besides, provision has 
been made for extra supply, in the suppression of the periodical 
monthly discharges. 

The rules for the diet in the early months of pregnancy are 
summed up in two words — moderation and simplicity. 

Quality and quantity must be looked to ; for if, unhappily, the 
pregnant female give way to fancy, and indulge beyond her powers 
of digestion, or cause irritation in the stomach by improper food, 
a state of permanent indigestion may become established, which 
may operate prejudicially, so far as to weaken the powers and 
bring on miscarriage. It may require some energy, or even forti- 
tude, to withstand temptation as to diet, yet it should and must be 
done. 

Rules for diet in the latter months are similar; and it is even 
more important not to err at this time, for vomiting, heartburn, 
constipation, etc., are readily induced. 

Cordials, and especially spirits or wine, are to be avoided, for 
their effects are doubly pernicious, to mother and to child. 

Longings. 

These fancies are often the mere offspring of the individuaFs will, 
who, under the cover of the risk that the child might be marked 
if her wishes are not gratified, seeks to obtain whatever she may 
long for. These fancies are, however, in some cases, the result of 
actual disorder, and of disorder of the brain, too, rather than of 
the stomach. They must, however, be firmly resisted from the very 
commencement, for then they are more easily conquered, though 
it will require much self-control on the part of the patient. Chalk 
is often greedily consumed ; and Dr. Dewees tells us of a lady who 
ate such quantities that her bowels were not opened for ten or 
twelve days together, and then only by injections, which brought 
away hardly any thing but chalk. She brought on indigestion, and 
ultimately died, having been rendered quite pale and bloodless, 
and as white as the chalk itself. She calculated that she devoured 
three half packs during each pregnancy. 

Dr. Merriman relates an instance of a longing for ginger, which 
had a pernicious effect upon the child. A young woman married to 
a gingerbread-maker, took a fancy, during her first pregnancy, to 



COSTIVENESS. 435 

cliew ginger. Of this spice she consumed several pounds. When 
the child was born, it was found to be small and meager ; its skin 
was discolored and rough, much resembling the scaly peeling-off 
of skin that takes place after some cases of scarlet fever. The 
child continued in ill health for several weeks, and then died. She 
had several children afterward, healthy and vigorous. The in- 
clination for ginger prevailed only with her first infant. 

I was consulted by a newly-married husband, who told me that his 
wife had a violent longing for an expensive muif, and had fright- 
ened him by saying the child about to be born would be marked 
with patches of fur, if she were not gratified ; and he said the ex- 
pense to be incurred was greater than he liked to pay, yet sooner 
than the child should be marked, he would buy the muff. He was 
assured that little risk of marking the child would be incurred by 
a refusal. He went away comforted, although he had been told a 
good deal about mother's marks. The child was born without spot 
or blemish. 

In these days, it hardly need be said that an ungratified wish of 
the mother can not impress an image of the thing longed for upon 
the child's body; but there is no doubt, as the above cited cases 
prove, that an indulgence in eating improper articles may be the 
cause of seriously impairing the health of the mother or child. 
Where there is a desire to eat chalk, we may do good by allowing 
some 30 grains of bicarbonate of potash, to be taken in the com- 
pound infusion of gentian, or of any other mild bitter; but medicine 
must be assisted by the determination of the patient not to give 
way to her inclinations. (See also page 439.) 

COSTIVENESS. 

Costiveness generally attends pregnancy, throughout both the 
early and late months. During the later months, exercise can not 
be taken, and the bowels will not act. This state and tendency 
must be obviated immediately; injections are the best means, or 
one or two of the mild aperient pills, consisting of three grains of 
compound extract of colocynth, and two grains of extract of hen- 
bane, will suffice, if taken occasionally at bed-time ; lenitive elect- 
uary has been much given, one or two drachms, with sulphur added; 
but the health must be attended to by taking as much exercise as 
can be borne, by daily ablutions or hip baths, etc., by regulating 



436 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

the diet, and bj not lying too long in bed in the morning. This 
last practice is found to be highly conducive to costiveness. 

Exercise 

must be taken during the first five or six months, unless there is a 
tendency to abortion; then passive exercise, that of riding in an 
open carriage, should alone be taken. But, in most instances, gen- 
tle exercise, so as never to fatigue, may be safely taken. In the 
latter months, caution as to exercise is necessary, for the first mis- 
carriage is a very serious matter, since it may lead to a habit. 

Late hours, and a round of parties, dances, etc., should all be 
avoided, together with heated rooms ; and both mind and body 
should be kept as quiet as possible. 

And here I would counsel against following the present and 
long-existing fashion of making a rapid tour of hundreds of miles, 
as the marriage trip. At no time does the newly-made bride 
require more care and gentle treatment than at this period ; yet 
the fashion has been to whirl her away from kindred and friends, 
in a state of excitement, to clamber over mountains, and to undergo 
many discomforts which she needed not to encounter. What has 
frequently resulted from this? Suddenly the lady is laid up, with 
symptoms of abortion; and then, without her customary medical 
attendant, she has to struggle unaided through a very serious trial, 
while her husband can only stand by and wring his hands. Under 
similar circumstances, in future, such a guide as this book will 
prove, it is to be hoped, would, by telhng what should be done, 
relieve much of the anxiety, and do substantial good besides. 

From mishaps like these, various embitterments of the future 
married life may arise — an irritable womb or vagina, inflammation 
of a wearing chronic nature, a habit of abortion, and many other 
evils. All heavy exertion must be avoided; nay, even in some 
persons of delicate health, even riding in a carriage must, during 
the later weeks, be avoided, if any jolting on a rough, uneven 
road be expected. 

Clothing. 

When ladies become pregnant for the first time, they are often 
very desirous of concealing the fact, and so, continue to wear their 
old corsets and old clothes, without any alteration being made in 



BATHING. 437 

tliem, to adapt them to the increased and increasing size. The 
corsets should have lacings over each bosom, to be loosened or 
tightened at pleasure ; and similar lacings should be made in the 
lower sides, to allow for the distension of the stomach. 

If, after repeated pregnancies, the size of the stomach has much 
increased, the muscles, from distension, probably will have lost 
their tone ; then a belt should be worn, to lace at front or back, 
and to exert a continued and a modified pressure at will of the 
wearer. A broad flannel roller, from six to eight yards in length, 
will be very serviceable. 

The feet must be well shod, and they should never be suffered 
to become cold, or wet, or chilled. 

Bathing. 

If a person have been accustomed to bathe, she ought to con- 
tinue the practice after pregnancy. After the morning bath, a 
short walk should be taken, to secure the glow which ought to fol- 
low bathing ; and this walk should be taken immediately, or as soon 
as possible. 

The body should be wiped quite dry, and as much friction used 
as can be without detriment. As to the forms of bathing, indi- 
viduals differ much ; some can only bear sponging with cold water 
in summer, with tepid in autumn and winter. Bay-salt may be 
added to the water with advantage. The shower bath may be con- 
tinued, if it have been previously employed, but the shock is too 
great to be encountered for the first time during pregnancy. 

The hip bath is preferred by me, or sitz baths. It should con- 
tain from three to four inches of water, in which the patient sits, 
the water rising to the navel ; the feet should be kept warm while 
in the bath, and a blanket should be thrown round both the bather 
and bath. In the warm summer months, and at all times in trop- 
ical climates, comfort will be derived from tepid ablution every 
day before the dinner hour. Let the lady sit in a shallow bath, 
and her servant sponge her with water at 85°, or pour over her a 
couple of pailfuls of water of the same temperature. 

A sitz bath at 85° for a few minutes, before going to bed, every 
night, is very refreshing. 



438 AMERICAN HOUSEHOLD BOOK -OF MEDICINE. 



The Breasts and Nipples. 

It is needless almost to say that any compression on the breasts 
and nipples ought to be avoided ; and, in addition to this, the nip- 
ples in a first pregnancy should be prepared for nursing for five 
or six weeks previous to confinement. The skin covering the nip- 
ples is generally so thin and sensitive, that the child's lips and 
tongue, in the act of sucking, soon make them tender and exco- 
riated ; and if this sensibility be not diminished, and the delicate 
skin rendered thicker and more callous before labor comes on, 
nursing will, in many cases, be necessarily given up soon after. 

Flannels or any thick covering must be laid aside. Daily, upon 
rising and going to rest, each nipple must be washed, either with 
green tea, or the infusion of oak or pomegranate bark ; and hav- 
ing been carefully dried, must be exposed to the air for eight or 
ten minutes, and rubbed gently, during this time, with a piece of 
soft flannel. 

One of the following lotions may be applied : 

No. 190. Tincture of opium 1 dr 

Tincture of myrrh .- 2 drs 

Distilled water 2 oz 

Mix, 
Or: 

No. 191. White vitriol 30 grs. 

Rose water 8 oz. 

Mix. 

Or a benzoin ointment or lotion is very efficacious. One drachm 
of tincture of benzoin to two ounces of alcohol, or spirits of rose- 
mary. 

Sore nipples and a wet-nurse will thus be avoided, in every 
probability ; but the nipples are sometimes very small, short, and 
consequently sunken in ; then they should be drawn out. A glass 
instrument, made like a tobacco-pipe, and used for drawing the 
milk from an over-distended breast, may be employed for this pur- 
pose. With this instrument the nipples should be daily drawn 
out, for months before delivery, until they are prominent enough 
to admit the child to suckle. 

What misery to mother and child may not thus be prevented! 
Yet do we ever hear of any pregnant female applying to her fu- 
ture accoucher, long before her delivery, to complain of the state 



THE BREASTS AND NIPPLES. 439 

of the nipples ? May those who read these passages, and who are 
in the state described, take warning, and set to in time to obviate 
evils of most serious magnitude ! 

I recollect one apposite instance of the danger arising from 
employing a wet-nurse, in which the child suffered, although the 
mother is the more likely of the two to be the sufferer. On "her 
first child being born, it was supposed impossible for the mother 
to suckle her child. He Avas placed with a seemingly healthy 
wet-nurse, and was afflicted with scrofula, in its varied forms, 
through his subsequent life ; while his younger brother, who was 
suckled by the mother, enjoyed a healthy and vigorous state of 
constitution. Blood-letting during pregnancy is often practiced 
by many, and the idea of its necessity prevails with the lower 
classes ; yet the practice may be injurious to the mother, by in- 
ducing miscarriage ; or to the child, by lowering its strength and 
natural vigor. It may be necessary to undergo this operation in 
some peculiar cases ; but medical advice should always be sought. 

Mental emotions in excess should be avoided; for miscarriage 
has frequently been caused by sudden fright, etc. A calm, equable 
temper, and a life of quiet cheerfulness and moderately active duty 
should be cultivated, for the sake of both mother and child ; nor 
should the husband be unmindful of attending to this point, and 
of sparing his wife all possible annoyance. 

Of longings, and of the power of the mother's imagination to 
mark the forthcoming child, mention has already been made. It 
would be a useless incumbrance to this book to relate some of the 
wonderful tales current, and undeniable facts told, of mother's 
marks on the child from ungratified longings. Dr. William Hun- 
ter took the pains to investigate two thousand cases of labor, and 
asked the woman about her longings, etc., and in the whole two 
thousand cases, he did not meet with one instance coincident. 

Children may be born with various marks and discolorations and 
deformities; and so are poultry, who have no imaginative parents, 
who are hatched with extra claws and other deformities ; yet if 
we are to believe in this parental power to produce such an effect, 
we are forced to believe that the hen must exert this power through 
the, shell ; and to reduce the matter to a still greater degree of 
absurdity, we must account for deformities which we often observe 
in chickens hatched in dunghills, stoves, or ovens ; for deformi- 
ties appear equally often in such births. 



440 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

If a pregnant female Will, as she ought to do, engage her ac- 
coucher early, and long before she expects to require his services, 
she should consult him on all points, and her mind may rest tran- 
quil and secure. 

Signs of Pregnancy. 

Ceasing to be unwell is the first sign. Some have married and 
conceived without ever menstruating, but these are rare excep- 
tions ; or the periodical discharge may be continued for the first 
three or four months, or even the whole period of pregnancy ; or 
conception may take place late in life, after menstruation has 
ceased. 

Suckling is supposed to prevent conception ; and many a poor 
mother has, under this erroneous notion, exhausted her strength 
by continuing to suckle for eighteen months or longer. Suckling 
mothers do not generally conceive during suckling, unless it is 
protracted beyond the period pointed out by nature. 

The continuation during pregnancy of a discharge looking like 
the periodical one is here mentioned in order to remove the notion, 
entertained by some persons, of the impossibility that such a dis- 
charge and pregnancy can coexist. In one case, the medical man 
declared, on this ground alone, that his patient was not pregnant, 
but dropsical; and actually proposed tapping, from which time 
alone saved her. 

But menstruation may have ceased, and yet pregnancy may occur, 
when various alarms about disease immediately arise. Wherefore 
it is well to be aware that thei^e are undoubted facts recorded of 
these late conceptions. It so happens that toward the end of wo- 
man's uterine life, a great disposition to pregnancy prevails. 

The succession to an estate in France was disputed because the 
mother was fifty-eight years old when the child was born. 

The cessation of the periods is not a conclusive evidence of 
pregnancy ; and there are many symptoms attending the period of 
cessation which easily may give rise to the notion of pregnancy, 
such as enlarged stomach, swollen breasts, while flatulence in the 
bowels may mimic the child's movements within the mother. What, 
then,' are we to depend upon ? When a woman ceases to be un- 
well, she is not certain from that alone of her pregnancy; but if, 
toward the third month — the suppression continuing — she recovers 
her health, her color, and her appetite, she needs no better proof 



SIGNS OF PEEGXAXCT. 441 

of pregnancy ; for under disease her health becomes impaired, and 
various symptoms of disorder arise. 

Morning SicJcness. — This is a very frequent sign. On first awak- 
ing, the woman feels as well as usual; she rises, and then a sen- 
sation of sickness comes on, and retching takes place even while 
dressing, or after breakfast. 

This sickness may occur from the beginning, or two or three 
weeks after conception. Sometimes it attends only the last two 
months of pregnancy, or it may be absent altogether. It con- 
tinues during the first half of pregnancy, and usually subsides 
when the child quickens ; that is, when the movements of the child 
begin to be felt. But sickness may arise from other causes than 
pregnancy ; if so, there will be other concomitant symptoms, and 
the health will be afi'ected ; whereas, in the sickness of pregnancy, 
the mother eats, and feels well in every respect. 

Enlargement of the breasts is hardly to be depended upon as an 
evidence of pregnancy ; for they may enlarge from increase of fat, 
or from suppression of the periods. In this latter case, the en- 
largement is but temporary. 

The nipple is a much more trustworthy criterion. Usually the 
areola, in some six or seven weeks after conception, is enlarged 
to an inch or an inch and a half, and it is of a darker color ; but 
the discoloration may be absent. Then, in pregnancy, the nipple 
is found turgid and prominent, and upon its surface will be seen 
little prominent points, from ten to twenty in number, and these 
prominences enlarge from the sixteenth to the twelfth of an inch, 
perhaps. Now these prominences, and the dark tint of the areola, 
with its rose-colored, yellowish hue, are very characteristic. Dr. 
Bull says he has never seen an instance where these prominences 
were truly developed without the presence of pregnancy. They 
may be absent ; but when present, they may be relied on. They 
appear mostly about a fortnight or so after conception ; and after 
delivery diminish as the milk leaves. 

The presence of milk is said to be a sign of pregnancy; this 
is an error; for milk has been secreted when there has been no 
pregnancy, in women who have ceased to menstruate, and even in 
men ; of all which occurrences there are undoubted records. 

Quickening. — This is the first sensation the mother feels of the 
life of the child within her womb. It seems at first to be like a bird . 
fluttering, and may come on so suddenly as to cause the mother to 



442 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

faint or to fall into hysterics. It recurs after a day or two, and 
then soon becomes more frequent and manifest. 

The period when this quickening takes place is uncertain; the 
time usually assigned is four months and a half, but it differs in 
different women, and even in the same women at different times. 

Dr. Bull, from his own calculations and tables, deduces that it 
takes place more frequently between the twelfth and sixteenth week 
than before or after these periods. Before the third month quick- 
ening seldom arises. 

Still, my readers must not be alarmed if no quickening occur, 
for it is sometimes, though rarely, absent, and yet pregnancy exists. 

If this quickening have attended former pregnancies, the sign is 
to be relied on, and is, perhaps, not to be mistaken. If the case 
is a first pregnancy, and doubtful, the occurrence of this sensation 
removes all further doubt, provided at grows stronger and stronger 
until the movements of the child are distinctly felt. 

The Prevention- or Relief of the Diseases of Pregnancy. 

A knowledge of the means to prevent or relieve the discomforts 
of pregnancy should be possessed by every married woman. 

Morning Sickness. — This occurs during the early or later months, 
and in the former case decreases or ceases after the quickening has 
taken place. 

A fluid, thin, limpid, and watery, is thrown up, and bile may be 
ejected if the vomiting continue long; then, in three or four hours, 
the patient feels quite well again, and is ready for her dinner. Now, 
this arises from irritation of the womb, and the sympathy excited. 
To relieve this, a compress is recommended. It is a belt from eight 
to ten inches in its middle and widest part, narrowing gradually to 
either end, in one of which is a slit through which the other end 
passes. To these are attached broad tapes wherewith to fasten the 
belt round the body. It is made of double sheeting or brown hol- 
land, lined with India rubber cloth, and has three or four straps 
passing across it, under which is placed a piece of linen five or six 
times folded, and previously wrung out of cold water. This wring- 
ing out is called refreshing the compress, and should be done every 
two hours, or oftener if it gets hot and dry. The belt is worn from 
the breast-bone to an inch and a half below the navel, and so firmly 
secured as not to admit the external air. 



PREVENTION OF THE DISEASES OF PREGNANCY 443 

Put this on half an hour before rising, refresh it every two or 
three hours, laying it aside just before dinner, and, of course, while 
taking a bath. Should the sickness prove obstinate, it may be 
reapplied an hour after dinner, and worn throughout the day. If 
this simple, but frequently efficacious, means fail, let the following 
draught be taken twice a day for several days : 

No. 192. Magnesia 15 grs. 

Tincture of calumba 1 dr. 

Distilled peppermint water 1 J oz. 

Or, a tumbler of warm chamomile tea, or even warm w^ater only, 
taken as soon as the qualmishness is felt, will, by inducing imme- 
diate vomiting, tranquilize the stomach and shorten the attack. 

Chamomile tea is made by pouring half a pint of boiling water 
over two drachms of chamomile flowers, letting the fluid stand for 
ten or twenty minutes, and then straining. This chamomile tea 
might prevent the sickness, if taken half an hour or an hour before 
rising from bed in the morning. 

If acid in the mouth prevail, magnesia, or potash, or soda car- 
bonates must be taken — from twenty to forty grains of the two 
latter, and twenty grains of magnesia, in a wine-glassful of milk. 
But alkalies often fail, and then acids must be tried — lemonade, or 
lemon-juice and water, whichever agrees best. 

Costiveness must be removed, if it exist, by Epsom or Chelten- 
ham salts every second or third morning, or when necessary. 

If the sickness is distressing, it is better to take no food at all for 
some hours after rising ; a little broth or weak beef-tea to moisten 
the mouth, and then nothing for five or six hours. 

"Where bile is thrown up, and there are furred tongue, confined 
bowels, and, perhaps, sick headache, a black draught of Epsom 
salts and senna should be taken, or blue pill and extract of colo- 
cynth. Then effervescing draughts. 

To keep the tongue clean, three grains of extract of aloes, with 
two grains of extract of henbane, two or three times a week, at 
bed-time. When the sickness has abated, and has left more or less 
of debility behind it — 

No. 193. Quinine 3 grs. 

Dilute sulphuric acid 60 drops 

Syrup of orange-peel 1 oz. 

Water, or bitter infusion 5 oz. 



A sixth part twice a day. 



444 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Should the sickness still continue violent, with fullness and pain 
at the pit of the stomach, or in the loins and hips, then a subin- 
flammatory state is present, and a few leeches should be applied ; 
and linen dipped in tincture of opium, or poultices with powdered 
opium sprinkled on them, should be frequently placed on the pit 
of the stomach. 

The sickness, which takes place about the sixth, seventh, or 
eighth month, arises from the distended womb affecting, mechan- 
ically, by its pressure, the coats of the stomach ; and the vomiting, 
if it be severe, may bring on premature labor. 

Here, the recumbent position to take off pressure ; a few leeches, 
rest, careful diet, a grain of extract of opium at night, and cloths 
dipped in tincture of opium to the pit of the stomach ; mild animal 
food, boiled or roasted ; chicken, game, mutton, or beef, roasted ; 
stale good bread, mealy potatoes, well-boiled rice, Jamaica sugar 
for the morning's coffee, and brown bread, form a sufficient hst of 
eatables. Gentle exercise may be allowed ; but if the patient over- 
exert herself in any way, or over-eat, or eat improper articles, a 
premature labor is not unlikely to be brought on. 

Heartburn in Pregnancy. 

Here acid is formed in the stomach, and rises into the throat, 
causing this unpleasant sensation. The carbonates of soda, pot- 
ash, and magnesia have been tried, and relieve for a time ; so do 
lime water, Carrara water, etc. ; but the best remedy is a tea- 
spqonful of sal volatile, with some magnesia in peppermint water; 
or this: carbonate of magnesia, 15 grains; liquor of carbonate of 
ammonia, 10 drops, in peppermint water, in an ounce of camphor 
julep or water. 

Costiveness is to be remedied, if it exists, and the diet regulated. 

COSTIVENESS DURING PREGNANCY. 

It is easy to imagine how important it is to keep the bowels 
open ; yet it is very common to see that this point is often little 
attended to. A hardened mass collects in the bowels, irritates the 
membrane to secrete a quantity of mucus, and slimy stools, with 
pain and griping, give an idea that the bowels are too loose ; yet 
the hardened feces remain. Chalk mixture has been given for this 



DIARRHEA DURING PREGNANCY 445 

state, to relieve the irritation caused by tlie hardness, when the way 
to cure was by opening the bowels. 

If the bowels threaten to become costive, as shown by the stools 
becoming harder, and either more scanty or less frequent, let the 
compress formerly described be first tried. 

If it fail, take a hip bath in the morning, at the ordinary tem- 
perature in summer, and in winter at 65 degrees, sluicing the 
stomach with water; then take a short walk. 

If this fail, an injection of warm water or of gruel. 

Of milk of sulphur, as much as will lie on a five-cent piece, 
put on the tongue and washed down with a glass of water, imme- 
diately before breakfast, will often succeed as the most complete 
imitation of nature. I give compound decoction of aloes, or baume 
de vie, as it is called, every night, or every night and morning. 
Stronger pills may be required, but hardly ever be needed, if the 
injection be repeated often enough. Strong aperients lose their 
effect, and require to be given in increasing doses, which do harm 
by causing irritation. 

Diarrhea, or Looseness of Bowels, during Pregnancy. 

This looseness of bowels may depend even on a costive state, 
or rather on a retention of the hardened excrementitious matter ; 
but too frequent motions may also depend on irritable bowels in 
this state. We should see if the tongue is clean or slightly white, 
and whether the appetite is good; if so, no medicines are neces- 
sary, but merely caution as to diet. But if the stools are liquid, 
dark-colored, and very offensive, the tongue coated, breath offen- 
sive, and there is loss of appetite, then the following draught has 
been recommended: 

No. 194. Rhubarb 8 grs. 

Ipecacuanha 1 gi"' 

Dill or mint water 1 oz. 

When the tongue cleans, an ounce or two of infusion of calumba 
or gentian, or any of the mild bitters, two or three times a day. 

If the looseness continue, flannel should be placed round the 
whole of the stomach and body; a flannel roller will answer the 
purpose well. Here attention to diet is important, because its 
quantity and quality should be such as to leave, after digestion, as 
little residue as possible, to pass through the bowels. 



446 AMERICAN HOUSEHOLD BOOK OP MEDICINE. 

Mild drinks for the first day or two — barley water or arrowroot 
without wine; tapioca, sago, and rice gruel, afterward; no solid 
food should be taken until the bowels are becoming quiet ; then 
chicken, game, roast mutton or beef may be cautiously allowed. 
Broths sometimes keep up the local irritability ; then rice, wetted 
only with broth or beef tea. 

FAiNTiNa Fits and Palpitations. 

Fainting is not uncommon during the early months of pregnancy, 
and may come on when there has been no previous exertion made ; 
but generally it ensues after exertions. The faintness, with or 
without consciousness, lasts a longer or shorter time. 

The mode of treating it is by recumbent position ; cold water 
sprinkled on the face, smelling salts to the nostrils, and cordials. 
Avoid all causes — hot and crowded rooms, violent exertions, etc. 

As to palpitation, it is the reverse state to that of fainting. 
They may occur at all times, often after meals, or on lying down 
at night ; mental emotions are a frequent cause. 

Treatment. — These attacks are very alarming, especially if oc- 
curring in the night, when the sufferer thinks herself in a dying 
state ; yet there is no real ground for alarm. The following mix- 
ture should be always at hand : 

No. 195. Compound spirits of ammonia i" oz. 

Camphor mixture 8 oz. 

Of this, two table-spoonfuls should be taken, as soon as the at- 
tack sets in, and repeated in an hour, if necessary. 

The hands and arms should be plunged into water as hot as can 
be borne, and great relief has been given by a foot bath as hot as 
can be borne, or with a table-spoonful of mustard to each gallon 
of hot water. 

Reassure the patient that she need not be alarmed. 

To prevent these attacks, take, for about a fortnight, of this 
electuary a tea-spoonful three times a day : 

No. 196. Carbonate of iron IJ- oz. 

Syrup of ginger 1 J oz. 

Taking care to regulate the bowels by extract of colocynth and 
henbane pills, or by decoction of aloes (baume de vie). An occa- 
sional aperient must not be omitted. 



PILES DURING PREGNANCY. 447 



Piles During Pregnancy. 

These are often met with, for costiveness causes them, and cos- 
tiveness is common at this time ; and there is also the mechanical 
bulk of the womb, which may operate as a cause. 

The piles appear as little tumors, within or just without, the 
bowel, and they either become solid and firm, or they break and 
bleed ; or there is a large swelling outside the bowel, large in cir- 
cumference, separable into distinct parts, " resembling a piece of 
sponge colored, and bleeding occasionally from its surface." 

The local symptoms are heat and sense of weight, desire to 
make water often, discharge of blood perhaps; and if the piles are 
external, they become irritated by the friction of the clothes, walk- 
ing, riding, etc. First, clear the bowels by half an ounce of cas- 
tor-oil; or they may be kept open regularly by the following elec- 
tuary : 

No. 197. Confection of senna (lenitive electuary) 2 oz. 

Flowers of sulphur 1 oz. 

Carbonate of magnesia 2^ drachms. 



Of this, a dessert-spoonful or a table-spoonful once or twice a 
day. 

An injection of either cold water, half a pint, or of warm gruel, 
may be thrown up — whichever may be preferred — only in intro- 
ducing the pipe of the instrument, care is requisite to avoid irri- 
tating the parts. The aperients should be so managed as, if pos- 
sible, to act toward the evening, for then a night's repose and a 
recumbent position diminish irritability. 

The local treatment is according to the local state ; if the parts 
are hot and irritable, leeches, fomentations, hot or cold poultices, 
frequently renewed. 

When inflammation is gone, apply on and around the tumors, 
every night and morning, some one of either of the following 
ointments : 



Or, 



No. 198. Powdered galls 2 drs. 

Camphor 30 grs. 

Lard 2 oz. 



No. 199. Powdered black hellebore root 1 drachm. 

Lard 1 oz. 

Mix. 



448 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

However annoying the piles may be, pregnancy is not the time 
to have an operation performed, that of tying them, etc. 

Some women never get rid of the piles, which began when they 
were pregnant, and which, in ninety-nine out of every hundred 
cases, would be avoided, if proper attention were paid to diet and 
to keeping the bowels properly open. 

The importance of having regard to these points can hardly be 
overrated ; and let every pregnant female keep a watch over these 
matters, for, if once piles are established, she will assuredly rue 
her misfortune and her fault during, probably, the whole of her 
remaining life. 

Enlarged Veins of the Legs. 

This affection sometimes arises during the latter months of preg- 
nancy, but not often; and the veins may become knotty. The 
pressure of the enlarged womb is the cause. 

A caUco roller, six yards long, and about three fingers wide, 
should be put around the limb, and rolled from the sole of the foot 
up to the knee ; a spare diet and open bowels, with more or less 
rest in the recumbent position, are necessary. If there is local 
heat, cold water or Goulard water applications will be of great 
service. 

Others complain of swelled legs during the day, and swelled 
face during the night's rest. The same treatment is applicable. 

Toothache during Pregnancy 

is often very distressing, and, if the tooth is carious, have it ex- 
tracted, though this should not be lightly done. (See Toothache 
for applications to the teeth.) And if the pain of the teeth and 
face assume a neuralgic or tic character, then carbonate of iron, a 
tea-spoonful twice a day, with an occasional aperient, washing out 
the mouth and teeth with warm water, and some common table salt 
in it. 

Salivation. 

A good deal of saliva is often formed, sometimes so thick as to 
cause nausea and retching; acid, too, attends. Here magnesia, 
about thirty grains, twice a day, and rinsing the mouth often with 
lime-water, are the remedies. 



DISTENDED AND PAINFUL BREASTS. 449 

Distended and Painful Breasts 

require fomentations, or sometimes cold applications ; Epsom salts 
every second or third day. 

When the breasts are not hot, rub with olive oil, an ounce, and 
tincture of opium, a drachm, night and morning. 

Cramps in Legs, or Sides, or Stomach. 

These cramps are painful and distressing ; walking about will 
relieve, or rubbing with camphorated oil. 

If in the stomach or sides, tincture of opium, twenty to thirty 
drops, with peppermint water, and tincture of cardamom, sixty 
drops. 

A sitz bath at 85° every night before bed-time, for ten or fifteen 
minutes, will often prevent these cramps. 

Violent Movements of the Child 

sometimes prevents sleep. Foment with flannel wrung dry and 
an opiate draught, not letting costiveness prevail. 

The Skin of the Stomach 

often becomes so distended as to fret, and even crack. Here fo- 
mentations, gently smearing with almond oil, and applying sperma- 
ceti ointment. 

When the size becomes inconvenient, a belt to fit, and a lace 
behind, is the only remedy ; it should press equally, and over the 
whole stomach, from the pit down to the hips ; lying down re- 
lieves it. 

Discharge during pregnancy, like the periodical, may lead to 
miscarriage, without proper care. Here perfect repose and lying 
down, while the discharge is passing away; gentle aperients, care- 
ful diet. 

The Bladder 

may be torpid, or it may be irritable ; in the first case, the water 
is retained too long, and the obvious remedy is to empty the blad- 
der at regular periods, and never to allow it to become distended. 
In irritable bladder, barley-water or linseed tea should be drank, 
29 



450 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

castor-oil given, and one physician recommends three or four grains 
of extract of henbane twice a day, for four or five days. 

Sometimes the womb presses so much that, on the slightest cough, 
etc., the water passes off; here lying down a good deal, and the 
abdominal or stomach-belt may be worn. 

If the external parts become irritated, Goulard water, or ice-cold 
water, and this last will often relieve itching ; if not, for itching 
apply a lotion of borax, J oz. ; distilled water, 16 oz., and cyanuret 
of potash, 10 grains. 

Leeches are sometimes necessary ; gentle aperients always. 

The Whites dueing Pregnancy. 

(See Leucorrh(ea or Whites for the treatment). An excessive 
discharge must be checked, or miscarriage might come on. 

Pain in the Side 

often comes on in the later months, never in the earlier. It be- 
comes violent after dinner — then lie down ; but it here depends on 
irritability of the liver, and requires active aperients. Calomel and 
colocynth, and seidlitz powder or Epsom salts' next morning. As 
soon as offensive discharges come away, this pain will subside. 

Headache 

is very troublesome with some. It may depend on a foul stomach, 
when there will be furred tongue, bad taste in mouth ; or it may 
depend on fullness of the vessels in the head, when there will be 
flushed face, dullness of eyes, and giddiness. 

For the first, aperients, with warm bath to feet, and cold at the 
same time to the forehead ; for the latter, blood-letting may have 
to be added. 

Jaundice may occur, but it will go off with its cause. Aperients 
here are also necessary. 

Miscarriage — its Prevention. 

It has justly been said that a medical man can do little to arrest 
miscarriage when the process is once set up, but much may be done 
to prevent its being set up, and to prevent a habit of miscarrying ; 
and all depends on the prudence and patience of the patient. 



MISCARRIAGE— ITS PREVENTION. 451 

The connection which exists in the early months of pregnancy 
between the future offspring and its parent is delicate, and the 
union is easily destroyed, but this only renders more apparent the 
necessity which exists for every possible precaution being taken. 

Two hundred and eighty days is the usual term of pregnancy, 
and the child may be expelled at any part of this period. If tliis 
event happen before the beginning of the seventh month, it is called 
a miscarriage ; but it often occurs within three weeks after concep- 
tion, but most frequently takes place between the eighth and twelfth 
week. If, during a pregnancy, a woman experience an unusual 
depression of strength and spirits, without any apparent cause — 
if this is accompanied with attacks of faintness, pains going and 
coming about the hips, loins, and lower part of the stomach — she 
threatens to miscarry. If these symptoms are, after a time, fol- 
lowed by the discharge of more or less blood, a partial separation 
of the child has already taken place. If the pains in the loins and 
hips increase, becoming sharper and more expulsive, and there is 
a bearing down, with a free discharge of clotted, bright-colored 
blood, the child is altogether separated ; and, in fine, if the blighted 
and dead child is not quickly expelled, thus terminating the whole 
process, this event may be looked for before many days elapse ; 
preceded, however, in such a case, by the breasts becoming flaccid, 
the stomach and bowels more or less disordered, and the discharge 
altered in appearance and offensive in character. 

Thus, the progress of a miscarriage is marked by the presence 
of a discharge, its quantity, and subsequent alteration of color. 

Causes. — Shocks or falls, violent exercise or exertion, violent 
purgatives or emetics, excessive mental emotions, and the force 
of habit. This last cause is much to be dreaded. 

Delicacy of habit, or weakness, on the one hand, and a very 
vigorous, robust state of the circulation may cause miscarriage. 

Treatment is divided into that of the preventive, and that of 
arresting the miscarriage when it has commenced. 

The preventive is, of course, to be put in practice when the female 
is not pregnant, and after she has conceived. This treatment must 
be varied according to the state of the constitution. 

In a woman of delicate health, feeble powers, and spare habit, 
every means should be taken to raise the tone of her health. To 
strengthen both the general and digestive powers, give a pill three 
times a day of one grain of sulphate of iron, one grain of sulphate 



452 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

of quinine, and two grains of extract of chamomile or of gentian. 
After these have been taken four or five weeks, one pill every day, 
one hour before dinner, may be taken. 

Occasional aperients promote the formation of good blood. The 
sitz bath every morning. 

Injections help much in keeping the bowels open ; drastic or 
forcing purgatives are to be avoided, for they irritate the womb 
and lower bowel. 

For diet, one kind of mild animal food, either mutton, tender 
beef, game, and poultry. Pork, veal, or lamb is to be avoided. 
Fish is objectionable, because it leaves a large quantity of excre- 
mentitious matter in the bowels ; mealy potatoes, well-boiled rice, 
stale bread or biscuit. For breakfast, weak black tea, or cocoa, 
brown bread, not toasted, and a new-laid egg are the best ; and 
cocoa instead of tea for the evening. 

Animal food may, in some cases, be allow^ed twice in the day ; 
but never in the evening. A glass or two of wine may be permit- 
ted at the end of the meal. 

An hour or two of rest, not sleep, after dinner. At night a hair 
mattress, and not a feather-bed, and no curtains to the bed except 
at its head. 

Bathing, or the hip or sitz bath twice a day, is excellent ; the 
temperature should at first be 65°, and gradually reduced to 55°. 
Used at noon and at five in the evening for five minutes, a quarter 
of an hour's exercise being taken before and after each bath. 

Change of air in some instances. 

Those who have had habitual miscarriage should take very great 
care ; they should avoid the chance of conception for full three 
months after the last miscarriage, because, in that time, the pa- 
tient's health should be reestablished ; and if the foregoing rules 
be observed, be reestablished in better state than before. Then, 
if pregnancy again occur, redouble all the precautions, keeping the 
bowels open, using the bath, looking to the digestion, secretions, 
and excretions, and avoiding all undue excitement of either mind 
or body. 

When the usual time for miscarrying approaches, the patient 
should lie down more than before, and continue to do so for five 
or six weeks after the usual miscarriage time has passed, by which 
time the patient may be safe. 

In some of these cases, I have met with the coincidence of a dis- 



MISCARRIAGE— ITS PREVENTION. 453 

charge of more or less of whites. I have stopped this by the mild 
injection of sulphates of zinc and alum, whereby such strength and 
local tone have been imparted, that I believe the injections, aided 
by the married pair keeping separate beds, have enabled the pa- 
tients to go past the miscarrying time, on to their full period. 

When miscarriage threatens a female of full, plethoric, robUst 
habit, we must avoid stimulants and tonics, and gently lower the 
excessive action which prevails. Gentle saline aperients, the tar- 
trate of potass ; no bitter infusions, no wine, nor malt liquor should 
be allowed, but rest in cool rooms, avoiding heat on all occasions. 
The diet must be sparing. Sitz bath as before, or cold salt water 
baths. 

Injections of cold water, or cold sea-water ; but, as before ob- 
served, the female syringes ordinarily used are objectionable, be- 
cause the pipe must be often withdrawn to refill ; so, a four-inch 
gum elastic tube ought to be substituted for the common ivory tube 
of the lavement pump, which may be of about half an inch in diame- 
ter. Several holes should be made in the point, which must be 
rounded off. 

When miscarriage seems to have already begun, and to be in 
the first stage, previously described, the recumbent position must 
be constantly maintained, on a cool horse-hair mattress or bed ; the 
diet must be sparing — toast and water, thin gruel, lemonade, sago, 
etc., with Epsom salts. When the symptoms of the second stage 
come on, and even here miscarriage may be averted, strict rest, 
linen dipped in cold or in ice-cold water to the parts, perfect absti- 
nence, and Epsom salts. With these, fifteen drops of dilute sul- 
phuric acid in one ounce of infusion of roses, with some syrup^ 
may be given every four or six hours. 

After all miscarriages, the sufferer should keep the recumbent 
posture for a week or ten days ; for, if she do not, and rise from 
her bed in a day or two, the womb, being still large and heavy, 
will fall down, forming prolapse or descent of the womb ; or else 
there will be a white discharge more or less profuse. 

To sum up, with respect to miscarriage, we may say that if all 
is done that should be, during the first stage, a female ought not 
to miscarry ; and, during the second stage, there is hope to be 
entertained, which may be realized; but in the third, all means 
of prevention are inefficient to avert the miscarriage. 



454 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



Of Calculating when Labor may be Expected. 

The duration of pregnancy, it is now pretty generally agreed, 
extends to two hundred and eighty days. 

But the main question is, to ascertain when conception took 
place. It is considered the surest way to allow two hundred and 
eighty days from the day after the last day of the woman being 
unwell. Thus, we are told a lady was taken unwell on a certain 
day, and continued so three or four days ; add one day more to 
these three or four days, and reckon forty weeks, or two hundred 
and eighty days from that time. 

Ladies should always make a mark in their almanacs — a cross 
will do — to point out when they menstruated, and another cross 
would note when the period ceased. This should be done both by 
married and single ; its utility is obvious to the former ; and to 
the latter it shows whether the periodical discharge is becoming 
more scanty, and does not last so long as before. Yet, for want 
of doing this, many a lady, when asked the important question. 
When were you last unwell ? is obliged to reply that she does not 
know, having forgotten. It does not come -within the author's 
scope to give directions how the labor is to be managed, an ac- 
coucher being generally engaged for the purpose. But he wiU 
direct here how the cord of the child is to be secured, if the in- 
fant happen to be born unexpectedly, when no medical man is at 
hand. Make two ligatures, each consisting of half a dozen threads 
of coarse, thick cotton. Bring the cord within view, without ex- 
posing the mother. With the first ligature, tie the cord about 
three fingers' breadth from the child's belly, and place the second 
about three fingers further still from the child ; and use just enough 
force to secure, but not to divide or cut through the cord with the 
ligature. The navel string may now be cut ofi" with a pair of 
scissors between the two ligatures, and the child taken away. 

Sore Nipples after Delivery. 

These often occasion great distress, which may be avoided if the 
directions which have been given in previous pages have been fol- 
lowed, for five or six weeks before delivery. Some advise the in- 
fant to be put to the breast as soon as possible ; but, as in first,' 
pregnancies no milk is secreted until after the third day from de- 



EXCESSIVE OR UNCONTROLLABLE FLOW OF MILK. 455 

livery, it had better not be done, since it can only irritate tbe nip- 
ples, and render them unfit for use. After the first child-be arino-j 
the infant may safely be put sooner to the breast. 

The child should not be allowed to have the nipple constantly 
in its mouth during the night; besides injuring the nipples, the 
child may suck too much. 

But if, after two or three days, the nipples seem to be likely to 
give trouble, a shield must be worn, and Needham's patent shield 
is recommended as the best ; to be worn during the acts of nurs- 
ing, care to keep it clean being taken. 

If the nipples crack or become painful, hot, and dry, but not 
chapped, apply a bread and water poultice, every four or six hours, 
and foment until the pain and heat give way. 

A metallic shield is worn between the acts of nursing ; the other 
is put on for nursing. 

Applications to cure these excoriations have been mentioned 
(see Breasts and Nipples) ; but I have never failed with the ben- 
zoin ointment or lotion. There are other applications, such as sul- 
phate of zinc, four grains to an ounce of water ; or, two grains of 
sulphate of copper to an ounce of camphor julep; or, one grain of 
nitrate of silver (called lunar caustic) to one ounce of rosewater. 

If these fail, the cracks may be touched with the caustic itself, 
and kept smeared or covered with an ointment, composed of two 
drachms of honey and one ounce of spermaceti ointment ; or thirty 
grains of Peruvian balsam, with one ounce of spermaceti ointment. 

Wash the nipple, before and after suckling, with a little milk 
and water ; and if one nipple alone is affected, let the child be 
suckled with the other. 

Prevent pressure by constantly wearing a glass, made for the 
purpose, or by any other contrivance. 

Excessive or Uncontrollable Flow of Milk. 

Here the milk tubes may have lost their elasticity, and with it 
their power of retaining the milk ; thus there is a constant drain- 
ing of milk from them. 

It is difficult to manage this defect ; a lotion of one drachm of 
alum to a pint of spring water, or thirty grains of the sulphate of 
zinc in a pint of decoction of oak bark, may be applied ; but al- 
ways wash away the lotion before suckling. 



456 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

If these fg.il, let a glass be worn to receive tbo milk ; and if the 
mother's health begin to suffer from the constant drain, then the 
child must be weaned ; and the sooner the better. 



Bad Breast, or Milk Abscess. 

There would not be so many cases of bad breasts, if suckling 
mothers would but attend to them in time ; when any threatening 
of inflammation in the breast appears, such threatenings require 
very prompt attention. 

This inflammation, terminating in abscess, may occur at any 
period of nursing ; but it is usual within a month after delivery, 
though it may be excited with the first coming of the milk. 

In this latter case, about the third day after delivery, the breasts 
become hard, swollen, and painful ; they increase in size, become 
knotty or lumpy, very heavy and very tender. If they be fomented 
and pressed gently, now that the milk is "at its height," a small 
quantity of milk will be seen to ooze from the nipples. The act 
of suckling causes pain, but soon great relief follows ; and, as the 
milk flows, the size and hardness of the breasts diminish. 

But the nipple may be flat, or, from some other cause or mis- 
management, the milk is not drawn away ; then a bad breast is 
threatened. To prevent this, give saline aperients ; tartrate of 
potass, sixty grains every four hours, until the bowels are open 
enough ; effervescing saline draughts to assuage the thirst, but no 
other drinks ; foment the breasts every third hour, for five min- 
utes, with flannels wrung out of warm water; then rub gently, or 
smear, rather, with a liniment, composed of an ounce and a half of 
soap liniment, and three drachms of tincture of opium ; then apply 
a large warm bread-and-water poultice, supporting the breasts by 
a suspensory silk handkerchief. After some six and thirty hours, 
relief will be experienced, and milk found in the poultice ; then 
draw the breasts gently by an attendant, or by means of a breast- 
pump ; after this, the suckling child may be put to the breast. 

The bad breast, which occurs three or four weeks after delivery, 
is often occasioned by exposure to cold, or by the stays pressing, 
or by sore nipples. Now, as soon as any uneasiness and heat 
mainifest themselves, or a lump is forming in the breast, or the 
child can no longer make the milk flow, lumps will form in the 
breasts, and the milk be suppressed. 



THE BREAST, OR MILKY ABSCESS. 457 

No time is to be lost ; apply leeches ; give saline aperients ; 
order a low and dry diet ; suspend the breasts ; gently rub the 
parts with the soap and opium liniment, and draw the breasts oc- 
casionally. Six or eight leeches may be applied several times, so 
long as the pain returns. 

The aperients ought to produce two or three watery discharges 
every day. To apply the liniment, warm a small quantity of it 
in a saucer ; then gently rub it over the breast for four or five 
minutes ; then take a piece of flannel, the size of the breast ; cut 
a hole in it for the nipple, soak it in the liniment, and put it over 
the breast, covering it with oiled silk, to prevent evaporation. 
Repeat this every three or four hours ; no poultices at this time. 
Drawing the milk is not to empty the breasts, but only to relieve 
distension ; so, a certain quantity only is to be taken away. Keep- 
ing the breast from hanging down is important. Rubbing with hot 
lard, and then covering with flannel, and ironing the breast with 
a smoothing iron, as hot as can be borne, has proved highly suc- 
cessful. 

The patient should lie in or on the bed, or on a sofa. 

If these means fail, an abscess forms ; then throbbing will be 
felt; apply poultices, and as soon as matter is formed, it should 
be let out. 

In some cases which have been neglected, I have seen young 
mothers who have sought relief for breasts, in which several holes 
existed, leading to one or more abscesses, and their constitutions 
have evidently been scrofulous. The quantity of matter discharged, 
and the preceding pain, etc., have usually much exhausted such 
mothers. Here I have met with the greatest success from apply- 
ing the alcoholic solution of iodine ; its strength should be that of 
twenty grains of iodine to one ounce of spirits of wine. This is 
to be painted, by means of a camel-hair brush, over the distended 
parts, avoiding the nipple and the discharging apertures — over 
which last some lint, spread with spermaceti ointment, may be put. 
The swelling and hardness rapidly disappear, and the matter ceases 
to flow after a time. The painting (if it may be so called) should 
be done night and morning; but if that be too frequent, which may 
be known by the skin shrivelling and threatening to scale ofi", once 
a day will be often enough, and even not so often in some consti- 
tutions, where the skin is very delicate and irritable. If, on look- 
ing at the breast, we find the brown walnut-juice-like color strongly 



458 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

tinging the «ldn, fresli iodine need not be applied, but merely wet 
the part by painting it with simple spirits of wine. 

The child should not be allowed to draw the breast if the matter 
of the abscess is mixed with the milk, or if much of the bosom be 
involved in the disease. 

The milk generally soon returns to the breast ; if not, the child 
must draw its nutriment from the other. 

Sometimes a hardness remains, which alarms many mothers, 
who dream of cancer immediately ; yet such hardness may be safely 
left to nature, or gentle frictions, twice a day, with soap liniment 
will help ; but if the iodine have been used, every particle of hard- 
ness is at last dispersed; or if not, by continuing the iodine, it will 
soon disappear. 

After Pains. 

After delivery, what are called after pains may be violent ; but 
they should not be too soon meddled with, as they effect a salutary 
purpose ; still, if they should be too violent, they may be checked 
by fifteen drops of tincture of opium in some water. They con- 
tinue usually, off and on, for about forty-eight hours. The patient, 
if any soiled linen is to be removed, must, on no account, be per- 
mitted to sit up in an erect position for one moment. 

It is presumed that a proper broad bandage has been put on 
before the labor commenced; the breadth should be such as will 
extend from the chest to the lowest part of the stomach. A new 
towel, that is large enough, will do, and this should be worn loosely 
during the labor, as it would derange too much to have to put it 
on afterward. 

The room must be darkened, no conversation allowed, and sleep 
must be sought for by the newly-delivered lady. An attempt to 
pass water should be made some seven or eight hours after de- 
livery, and if there is any difficulty, warm flannels, wrung dry out 
of hot water, should be applied. No one must be deceived by a 
few drops only passing, as may happen; the bladder should be 
emptied. 

On the evening of the second, or morning of the third day, some 
aperient should be given ; and castor-oil is the best, a table-spoon- 
ful of which should be poured upon a two-thirds filled wineglass 
of milk, coffee, or mint-water. If necessary, this must be repeated 
in four or five hours. Or, what is preferable, an injection of two 



AFTER PAINS. 459 

table-gpoonfuls of castor-oil in a pint of gruel or barley-water, 
may be thrown up. 

As the recumbent position induces confined bowels, they must 
be watched. 

A discharge takes place from the parts, which usually continues 
two or three weeks, though it varies as to quantity and duration. 
It is reddish at first, then greenish, yellow, and at last resembles 
soiled water. If this should ever suddenly stop, attention must 
be paid as to whether cold has been taken or inflammation set up. 
In this discharge, an injection into the front passage should be or- 
dered of tepid milk and water, three or four times a day for the 
first week, and gradually left ofi". 

This discharge may become too profuse, and afi'ect the health 
and nursing; then a slight injection of alum and tepid water will 
check it. 

Cleanliness is essential throughout, but the linen must be well 
aired. The milk, in a first confinement, comes into the breasts 
about the third day; the infant may, however, be sooner applied 
to the nipple. There may be slight pain at first, which soon ceases, 
and the previous knotty hardness of the breasts, if any have formed, 
will soon go ofi". The infant should be put to the nipple within 
the first twenty-four hours, as soon as the mother has had a sleep ; 
this is done in order to draw out and form the nipple for suckling, 
to excite the secretion of milk, and to prevent the knotty hard- 
ness which might otherwise arise. 

If the breasts remain hard and knotty, and the child can not 
suck, rub the lumps with warm almond oil, and foment assiduously. 
The recumbent position should be maintained for the first two 
weeks rigidly, and occasionally for the third week. Even sitting 
up, with the legs on a level with the body, should not be allowed ; 
much mischief has so been done ; and with the poorer classes, 
where the women are obliged to get up sooner and go to work, pro- 
lapse, or coming down of the womb, is a frequent consequence. 

The bandage around the stomach, of which we have spoken, has 
been tightened according to circumstances ; but a properly ad- 
justed belt must be substituted when the patient begins to move 
about, and the belt should be worn so long as the muscles of the 
stomach require support. 

Diet, for several days after delivery, should be small in quantity 
and simple in quality. Cofi'ee in the morning, a light pudding for 



460 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

dinner, and coffee or tea for the evening, with gruel in moderation 
between times, if desired. On the fourth or fifth day, the wing of 
a chicken or a mutton-chop may be eaten, with equal parts of bar- 
ley-water and milk for beverage. About the fifth day, the patient 
may recline on the sofa, but she must be moved without any exer- 
tion on her part; nor should she dress herself, putting on stays, 
etc. If it is winter-time, the bed should not be left for a few days 
later. 

The ninth day is considered by many nurses as a critical day, 
but it is no more critical than any other; and the idea would be 
as harmless as the day itself, did it not excite an anxiety which 
might lead on to mischief. 

After the tenth day, the accouchee may be wheeled into an ad- 
joining chamber, still lying on the sofa. 

As to what drinks the nursing mother should have, we will quote 
an experienced midwife's opinion with respect to wine or beer : 
" I am daily more and more convinced that a healthy woman is bet- 
ter without either, both for herself and her child. Her own health 
will be less likely to be deranged ; her own feelings and sensations 
will be infinitely more equal and comfortable, and the milk secreted 
in her bosom will be more pure and nourishing ; and, as a conse- 
quence of all this, the child will thrive and flourish better without 
the stimulant than with it." He recommends the barley milk, 
above described, as the best beverage for mother and child, so long 
as the mother can not take active exercise in the open air; but 
to those who are weakly, the bitter ale may be useful. In such 
cases we may try it ; if no disturbance ensue, we may continue to 
allow it. 

Washing the child the first time is an important operation, for 
lamentable consequences have ensued, where it has been intrusted 
to ignorant, unreflecting minds. 

The body of the child at birth will be covered with a white, 
greasy, curd-like substance, particularly about the eyelids, groins, 
armpits, and various folds of the skin. This adheres very closely, 
and is difficult to remove ; yet if it be allowed to remain, it would 
become hard from drying up, and cause much irritation. We dare 
not rub, except in the most gentle manner ; the skin of the infant 
easily excoriates. Water will not act upon it, and soap has very 
little effect; but lard renders it soluble. Smear, then, the whole 
of the body with fresh lard ; then put the child into warm water 



AFTER PAINS. 461 

(from 96° to 98° of Fahrenheit), and after five minutes, with a fine 
sponge, sponge the child while still in the bath, with the least irri- 
tating soap that can be got. If the whole can not be removed, 
leave the obstinate remainder to a second washing. Warm water 
must always be used to an infant which, up to nearly -that mo- 
ment, has been used to one uniform degree of temperature. 

The same accoucher wdio recommends us to act in this way, cau- 
tions nurses to wash the infant in the bath, and not on the lap ; for 
its bones are soft, and incapable of sustaining its own weight in 
any thing approaching to an erect or sitting posture. In Germany 
a bath is used well adapted to this purpose ; it is made of wood, 
oval in shape, with a raised portion at one end for the head, and 
deep enough to contain a quantity of water just sufficient to cover 
or float the child ; and yet none of the dirty water of the bath should 
be suffered to touch the eyes. 

Sometimes there is no milk for the child until the third or the 
fourth day after delivery ; then we may give of asses' milk and boil- 
ing water equal parts, or of cow's milk one-third and boiling water 
two-thirds, slightly sweetening the latter with loaf sugar. A few 
spoonfuls of one or other of these are to be given through the suck- 
ing-bottle, and not from the boat or spoon, to avoid over-distension 
of the infant's stomach, for the infant will not suck too long. 

For the first week or ten days the infant requires frequent suck- 
ling, but from the tenth day until the end of the lying-in month, it 
may be nursed every four hours. 

After the lying-in month, night nursing should be done away 
with ; the child should be suckled at ten o'clock at night, and not 
again until five the next morning, unless the infant is particularly 
feeble, when so long an interval can not be borne. 

When the first teeth appear, the mother will require, probably,, 
some help; and artificial food may be given twice in the course of 
the day, without any injury to the child. Grood fresh cow's milk, 
with or without water, crushed crackers, sago or arrowroot made 
with milk; or, if these disagree, weak beef-tea, veal or mutton broth, 
clear, and free from fat, mixed with an equal quantity of farina- 
ceous food, and a little salt, may be given. The child should never 
receive its food lying ; the head should be raised. 



462 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



WEANma. 

Weaning the child should take place by the ninth, and not later 
than the twelfth month, unless peculiar circumstances demand that 
it should take place sooner or later. The weaning must be grad- 
ual, by diminishing the number of times every day for suckling the 
child. 

Drying-up the Milk. 

This may become necessary from the death of the child, or the 
impossibility of suckling ; and it is usual to apply cold evaporat- 
ing lotions. These, however, may prove dangerous, and the safest 
application is, liniment of compound soap liniment, 3 ounces ; tinc- 
ture of opium, 1 drachm ; camphor liniment, 1 drachm ; or, if this 
be too stimulating, use the compound soap liniment alone. Apply 
one of these warm, covering the linen or flannel with oiled silk. 
We should, besides, gently rub the breast for eight or ten minutes, 
every four hours or thereabouts, with warm almond oil. 

We should not empty the breasts, for fresh secretion is encour- 
aged ; but if the distension and hardness are very great, they may 
be partially emptied. The bowels should be rather free, where- 
fore a saline aperient should be given every morning to secure this 
effect. The diet must be scanty; little or no drink, but only solid 
nutriment allowed. The mouth may be washed out with toast and 
■water, or a little fruit may be allowed. 

As to drying up the milk at the regular time of weaning, the 
mother has been prepared by the child having been artificially fed 
for some time ; but if the breasts give trouble, act as above stated. 
Aperients must not be neglected at this time. 

About the sixth or seventh month, w^hen the teeth begin to ap- 
pear, the artificial food may be increased in quantity and strength — 
cow's milk, pure and undiluted, with farinaceous food ; and when 
the grinding-teeth begin to appear, beef-tea, chicken, mutton or 
veal broth, once a day; but the broth must consist of a pound of 
lean beef cut into small bits, and then be macerated in cold water 
for three houi^, and slowly heated to boiling ; then boiled for a 
couple of minutes, and strained. A portion of soft-boiled egg may 
be tried, or a small bread-pudding with one egg in it, for dinner, 
may be given. Some give animal food at this period, but it has 
been appositely said that "the practice of giving animal food to a 



PUERPERAL PERITOXITIS. 463 

toothless child is not less absurd than to expect corn to be ground 
where there is no apparatus for grinding it." 

From the sixth month to the end of the second year teething is 
going on, and consequently irritation is easily excited ; wherefore 
we can not be too cautious about the diet, for, by due attention to 
it, we may frequently prevent the formation of annoying eruptions, 
of the thrush, diarrhea, rickets, and may even check scrofula from 
manifesting itself. 

If food disagrees, diarrhea arises, or flatulence and gripings, 
we should not immediately resort to medicines, but try first what 
change of food will do ; for instance. Dr. Bull says diarrhea may 
be checked by giving some sago, thoroughly boiled in very weak 
beef-tea, with the addition of a little milk ; or by two-thirds of ar- 
rowroot with one-third of milk ; or, for a few days, arrowroot made 
with water only. Costiveness may often be removed by changing 
the food to crushed crackers steeped in boiling water, with a small 
quantity of milk added ; or Densham's Farinaceous Food (a mix- 
ture of three parts of the best wheaten flour and one part of the 
best barley meal) is useful, on account of the laxative influence of 
the barley. A table-spoonful is to be mixed with a small quantity 
of cold water; add half a pint of boiling water, constantly stirring ; 
boil eight minutes, strain ; add a small quantity of unboiled, pure, 
fresh cow's milk, a little loaf sugar, and a few grains of salt. 

Flatulence and griping usually are caused either by too much 
food, or by food over-sweetened, or by its not being fresh prepared 
for every meal. The remedies are obvious ; but we had better give, 
in these cases, weak chicken broth or beef-tea, freed from fat, and 
thickened with soft-boiled rice or arrowroot ; but, above all things, 
we should always try what change of diet will do before giving any 
of the nursery medicines — the gray powder, calomel, rhubarb, etc., 
which some mothers are too fond of administering. 

We will now, to close this part of our subject, advert to various 
morbid states, which often put the puerperal patient's life in dan- 
ger; and, first, of 

Puerperal Peritonitis, or Inflammation of the Membrane 

LINING THE BoWELS AND THE AbDOMEN INTERNALLY. 

On the second, third, or fourth day after delivery, a severe shiv- 
ering comes on ; then an acute pain in the abdomen is felt low down. 



464 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

This .pain is constant — sometimes increased; but it is always in- 
creased on pressure, and by any movement of the muscles of the 
stomach.. The milk and the discharge are checked, if not stopped 
altogether; the skin is hot; pulse small and frequent, in others 
full and bounding up to the fingers ; the tongue furred, the head 
aches; the countenance is high-colored; restlessness and sleepless- 
ness ; vomiting occasionally; breathing hurried and anxious. As 
the disease progresses, the abdomen becomes tense like a drum, 
the fever increases, delirium supervenes ; the tongue becomes dry 
and brown, the teeth covered with dark stuff, as we see in typhus ; 
other symptoms come on, and precede a fatal termination. The 
causes are contagion, and those of inflammation ; and it is, at times, 
epidemic. 

Treatment. — Almost the sole chances of the patient's recovery 
are derived from early treatment, and from the epidemic being of 
a mild character. 

If seen during the shivering, hot fomentations or poultices over 
the stomach. Three grains of calomel, with as much James's pow- 
der, and half a grain or a grain of opium, should be given ; and in 
two hours an ounce of castor-oil, or some salts and senna. Warm 
water injections, and also injections of warm water into the front 
passage, two or three times a day. 

If the fever is not very high, the pain not great, leeches should 
be applied, and we.need not bleed from the arm; but if the symp- 
toms run high, one or two bleedings from the arm may be neces- 
sary ; and we must then rely on four or five grains of calomel, with 
five of Dover's powder, every third, fourth, or fifth hour, till the 
gums are affected, when amendment and recovery usually follow. 

When the hot skin yields, and the abdomen remains distended, 
with sinking of the strength, cold legs, weak pulse, and little or no 
pain, do not despair, but give stimulants — wine, brandy, and am- 
monia, freely administered. (See Typhus Fever.) 

Malignant Puerperal Fever. 

Shivering not so marked as in the foregoing ; the pain less severe, 
deeper seated, more circumscribed ; the pulse small, rapid, weak, 
numbering from 130 to 160 in the minute ; skin yellow ; anxiety; 
mind wandering ; tongue white, then yellow, then brown ; vomit- 
ing, hiccup, diarrhea ; the motions are very offensive ; the usual 



PUEPLPERAL INTESTINAL IRRITATION. 465 

discharge is of bad smell, or is altogether suppressed ; delirium, 
drum-like stomach. 

Treatment — similar to the foregoing, only bleeding is hardly ever 
necessary ; leeches are useful ; fomentations, the calomel, antimony, 
and opium powders. When collapse or sinking comes on, stimu- 
lants and support. 

Convalescence is often protracted ; and, in some cases, deposits 
of matter take place in various parts — in the joints, in the womb, 
in the eye. Strong broths, jelhes, wine and cordials must be given 
early in this fatal disease, even while we are applying leeches ; and 
the disease attacks so insidiously that we should take alarm, and 
be on the watch, when we find the pulse keeping up above 100 for 
some days after parturition. 



Puerperal Intestinal Irritation. 

General uneasiness, if the bowels have been neglected ; loss of 
appetite, tongue furred; chills, then flushes; headache, frequent 
pulse ; abdomen large and tense ; deep-seated pain, but slight, and 
relieved hy pressure; vomiting, diarrhea; all evacuations offensive; 
stools dark, slimy or watery ; flatulence, badly smelling breath. 

Treatment. — Empty the bowels by castor-oil or Epsom salts and 
senna ; enemata (clysters) of warm water ; the gray powder three 
grains, with three or four grains of Dover's powder, every four 
hours. For diet: arrowroot, gruel, broth, jelly, milk, with soda or 
seltzer water, is grateful. Nourishment, but not stimulus, unless 
signs of sinking come on. 

False Puerperal Peritonitis. 

This occurs in delicate nervous females, after severe after-pains, 
and sometimes after an active purgative. There will be slight shiv- 
ering ; pain and tenderness of the abdomen ; tongue shghtly coated ; 
pulse rapid but soft ; skin not hotter than natural, or but little hot- 
ter ; no anxiety of countenance ; strength not much impaired. 

Treatment. — Fomentations, poultices, sweating medicines, opium, 
with mild laxatives occasionally. Five to ten grains of Dover's 
powder, every four or six hours ; or twenty or thirty drops of tinc- 
ture of opium, and repeated if necessary The attack seems allied 
to hysteria. 
30 



466 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



Milk Fever. 

In all lately-delivered women, after or about the third day, there 
is some disturbance of the nervous and vascular systems. 

Shivering occurs ; then pain in the head, with throbbing ; light 
and sound annoy ; the pupils of the eyes are contracted ; counte- 
nance flushed ; pulse frequent, full and hard ; skin hot and dry ; 
tongue dry and coated ; thirst excessive ; the milk is no longer 
secreted ; the breasts become flaccid ; delirium sometimes sets in. 

Causes. — A heated atmosphere, undue exertion, mental agita- 
tion, excessive use of stimulants. 

Treatment.— We must subdue excess of action by aperient med- 
icines ; saline medicines, with the sixteenth of a grain of tartar in 
each saline draught, every four hours ; low diet, rest of mind and 
body ; cool air, and diluting drinks. 

If symptoms are severe, blood-letting ; tartar emetic, 1 grain in 
6 oz. of water, a table-spoonful every four hours. If a feeling of 
sickness ensue, discontinue the medicine ; mercurial purgatives, 
such as calomel and colocynth pills, 2 grains of calomel and 6 of 
colocynth ; cupping or leeching the head or temples ; cold lotions 
to them ; hot water to feet, or mustard foot baths. Draw ofi" the 
milk gently, and foment or poultice the breasts ; also apply the 
child to the nipple to stimulate secretion. 

Our treatment of all these disorders is based upon general prin- 
ciples. Inflammation is to be subdued whenever it exists ; the 
strength is to be supported, when it is failing, by stimulants, etc. ; 
and where there are nervous symptoms, much pain, irritation, or 
restlessness, opiates must be resorted to. 



DISEASES OF CHILDREN. 467 



CHAPTER VI. 

DISEASES OF CHILDREN. 

A HEALTHY child has all the parts well rounded ; and it has been 
observed that, whether the limbs are bent or straight, every line 
forms a portion of a circle; no muscle can be seen through the 
skin, nor the joints be found easily, except by observing the bend- 
ing of the limb. 

Whenever the joints can be seen, the child is not in health ; and 
if the anterior part of the chest is raised, while the sides are 
sunken, it is a sign of ill-health ; if the belly project too far, and 
is too full or hard, there is disease probably; also, if it is concave 
or sunk. The child should be neither too fat nor too lean. 

Drawing up of the legs toward the body, with crying and pain 
or local tenderness, are signs of disease. 

A young child in health seldom raises its hands above the mouth ; 
when it does, there may be too much blood, or some disease in the 
head and face. 

Starting from sleep, or starting when awake, portends disease ; 
though it may be caused by irritation of stomach or bowels, easy 
to be removed. 

The eyes should be clear and lively, and not thrown upward ; if 
children cast their eyes upward, it is probable that opiate* may 
have been given them ; and if the eyes have gained the habit of 
being directed to the same object, and they afterward lose that 
power, disease of the head is not unlikely to come on. 

Contracted pupil shows irritation. 

The stools, again, are indicators of disease. The natural motions 
are two, three, or four, in every twenty-four hours, and the natural 
color is a light yellow. The first which pass after birth are gen- 
erally black ; if they are green, white, or clayish-colored, or mucous 
or watery, there is irritation in the bowels. 



468 AMERICAN HOUSEHOLD BOOK OE MEDICINE. 

It has been said that the infant's first motions are dark or black, 
consisting of what has been called meconium ; and the retention 
of this is considered to be so prejudicial that castor-oil or calomel 
is forced down soon after birth. This practice is injurious, and in 
respect of calomel especially so ; because such a drug as calomel 
must irritate the tender and highly sensitive bowels of the newly- 
born infant. 

Castor-oil is not so irritating ; and when the abdomen (belly) of 
the child is full, and no evacuation has taken place for five or six 
hours after birth, half a drachm — that is, thirty drops — of castor- 
oil may be given ; before that period of six hours, it is better not 
to disturb or irritate its stomach by any medicine whatever. 

The mother's milk has been said to possess a purgative quality; 
but it is probable that it acts and excites by merely mechanical 
distension. 

The child should not be applied to the breast until there is an 
appearance of milk in it, which often happens after ten or twelve 
hours' rest. And during the first five or six months the infant 
must be suckled during the night as well as the day, but at regular 
intervals of four hours. 

The child should not be sufi'ered to retain the nipple in its mouth. 

The mother is able often to supply milk enough for the first seven 
or eight months ; but after that time, the infant would be insuffi- 
ciently nourished, if it depended on the mother alone ; then food 
must be given; for the child must not want nourishment that will 
agree with it. 

If the deficiency of food can be supplied by artificial food, with- 
out the infant suifering, no further change is necessary ; but if this 
can not be done, a strange nurse must be employed. 

Great care must be taken in the choice of a nurse ; she should 
be exgLmined, so that no unsoundness or defect escape detection. 
She should not be too old, and the more recently she has been con- 
fined, the better ; and if she has had one or two children it will ba 
all the better, because she will probably have more milk secreted. 

If we are forced by circumstances upon artificial feeding alto- 
gether, great care is required. 

The best substitute for human milk is good cow's milk ; but as 
it is thicker and whiter, and not so sweet as human milk, we must 
add to two parts of it, one of very thin barley-water, and sufficient 
w^hite sugar to make it sufficiently sweet. 



DISEASES OF CHILDREN. 469 

Asses' milk, again, approaches more nearly what we require ; 
but it is richer, and requires to be diluted with about a third part 
of water. This can be used if the cow's milk disagree. 

As the child becomes a little older, thin bread pap may be given, 
and occasionally some light beef or chicken tea. Thin bread pap 
is made by steeping soft bread in hot water, with the addition of 
a little sugar and fresh cow's milk. 

The spoon is the best vehicle, better than the sucking-bottle ; 
and the child must not be placed horizontally on its back ; but its 
head should be kept elevated, and its actions carefully attended to, 
so that we may be enabled to stop the moment it appears to be 
satisfied. 

The food will require to be varied, since one kind may agree 
well with the infant, at first ; but may, after a little while, derange 
the bowels, producing gripes, acidity, and purging, or costiveness. 
Prepared barley, with water and unboiled or boiled milk, or arrow- 
root, can be given. 

One rule requires strict attention ; to keep the bottle, or what- 
ever is used for this purpose, very clean. It is of great impor- 
tance to prevent acid fermentation in the child's bowels. 

Every kind of food should be given tepid or lukewarm. 

Medicines for Children. 

The quantity in which medicines ought to be given to children 
difi'ers very considerably from the doses taken by grown-up per- 
sons. These doses are to be regulated chiefly by the respective 
ages ; and the following table has been constructed, which may be 
received as a guide. If we suppose the dose for a grown-up per- 
son to be sixty grains, or a drachm, then the quantities are thus 
graduated : 

Table for Doses. 
Let the dose for an adult represent 1 say 1 drachm. 





for a 


child? years old J- " 1 scr. or 20 grs. 




(( 


4 years oM \ " 15 grs. 




(( 


3 years old J " 10 grs. 




(( 


2 years old ^ " 8 grs. 




(( 


''z::'{t'}'-''- 



But it is a good practice to give medicines in divided doses, so 
as to insure the result, neither more nor less. 



470 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Opiates, if ever given, demand close watching ; and purgatives 
must be quickly repeated, or much time may be lost. 

They should be given either in a liquid form, or in that of pow- 
der ; and those should be selected which are most free from nau- 
seous taste or smell. Sugar or syrup may be added. Powders 
should never exceed in quantity ten grains, on account of the bulk. 
The dose of a liquid is from a tea-spoonful, or a drachm, to that 
of a dessert-spoonful, or two drachms. 

Alteration of diet will often supersede the necessity of giving 
any medicines at all ; and this should be always attempted. The 
infant can not exist many hours without food ; it must not, there- 
fore, be left too long without some kind of sustenance. During 
febrile or inflammatory complaints, barley-water, whey, or thin 
gruel should be given ; the breast-milk, even, may be too stimu- 
lating, and will require to be mixed with water ; or lighter drink 
must be given, but at short intervals. 

If considerable debility be present, the diet should be more nu- 
tritious. 

Mercury. — Mercury, which, given in sufficient quantity, will sali- 
vate almost any one, does not seem to be capable of salivating an 
infant. 

We can not, therefore, administer this remedy to salivation when 
we willingly would do so, as in cases of croup, inflammation of the 
brain, etc. ; and this is the more to be regretted, on account of the 
natural irritability of the child's stomach and bowels preventing us 
from using another medicine, which powerfully controls inflamma- 
tion — the tartar emetic. Mercury, however, is still of great serv- 
ice ; probably by its influence over the secretions. Calomel is a 
very useful medicine in the hands of the medical practitioner ; but 
it should be given with caution by any one else. Yet some moth- 
ers seem to think it almost a remedy for every disorder in the child. 
Calomel acts very speedily on the secretions ; and the motions soon 
give evidence of its power, by their unnatural appearance. They 
at last become of a greenish color; and these green motions are 
called bilious motions, the green being derived from the vitiated 
bile, which, doubtless, say the mothers, was doing, or was about to 
do, much mischief. And then more calomel is given, in spite of 
the gripings, the drawing up of the child's legs toward the abdo- 
men, of the local heat or tenderness, and a state of inflammatory 
irritation is brought on. 



MEDICINES FOR CHILDREN. 471 

That this statement is correct, any mother may convince herself 
of by discontinuing the calomel ; and if inflammation of the bowels 
have not already been excited, the motions will reassume their 
natural appearance, and all signs of local suffering will cease. The 
greenish appearance can soon be altered by giving a little carbon- 
ate of potash or soda, two or three times a day, in some dilute dill 
water. 

The dose of calomel is from one-fourth of a grain to two grains ; 
and it is usual to give some castor-oil, or other aperient, in two or 
three hours. 

■ The powder called gray powder, consisting of mercury with 
chalk, or with magnesia, is a very useful form of medicine for chil- 
dren. In diarrhea it may be combined with Dover's powder. Dose 
for an infant is one grain, and for a child two years old, two grains. 

The Aromatic Spirit of Ammonia acts as an antacid and stimu- 
lant. Flatulence and acidity are relieved by it; and whenever 
there is debility or exhaustion from fever, erysipelas, convulsions, 
etc., we shall find it a very useful remedy. 

Dose from two to eight or ten drops, in water, or in dill water. 

The Carhonate of Ammonia^ or Smelling Salts, is another form 
of ammonia, and useful for purposes similar to those requiring the 
spirits of ammonia. Dose, one grain to an infant under one year 
old, in syrup and water; two grains, if older, up to three or four 
grains. 

Antimony may be given to excite sweating or vomiting, accord- 
ing to the dose. James's powder is very valuable in fever, and 
so is tartar emetic in various diseases — croup and inflammations. 
One grain of James's powder to a one-year old infant, two grains 
to one of two years of age, and three grains to older children. 
Give it in molasses, syrup, jelly, or gruel. The dose of tartar 
emetic is from one-eighth to one-sixteenth of a grain. Its action 
is followed by depression, hence its use in inflammations. If irri- 
tation exist in the stomach and bowels, we must not give it. 

Antimonial Emetic Mixture. 

No. 200. Distilled water IJ oz. 

Tartar emetic 1 gr. 

Simple syrup J oz. 

Mix. 

Here one drachm, or about a tea-spoonful, contains the sixteenth 

of a grain ; and give one, two, or three tea-spoonfuls, every quar- 



472 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

ter of an hour, until vomiting occurs. The action will be more 
certain and less violent, if half an ounce of ipecacuanha wine be 
added. Some children can not be made to vomit. 

Camphor.— This exhilarates and causes perspiration ; but many 
do not like to give it to children. Camphor mixture, or camphor 
julep, is the form ; a table-spoonful to a child two or three years 
old. 

Castor-oil is particularly useful. The bowels are left relaxed ; 
30 to 60 drops the dose, with a little sugar. 

Castor-oil Emulsion. 

No. 201. Castor-oil 1 oz. 

Burnt magnesia 2 drachms. 

White sugar 3 " 

Oil of aniseed 2 drops. 

Mix. 

One or two tea-spoonfuls to a child one or two years old, and 
repeated if necessary. 

Chalk. — Prepared chalk, or the compound chalk powder, is a 
very useful antacid ; and whenever the motions are too free, or 
greenish, or of a green color, 3 or 4 to 10 grains, mixed with 
sugar, gum arable, and water, will relieve. The green color is 
supposed to arise from the action of the gastric juice upon the bile, 
and such stools do not demand calomel. Eruptions on the skin 
are usually mixed up with, or arise from, acid in the stomach ; and 
chalk will do good. 

Compound powder of chalk is one form in which to give chalk ; 
dose, 2 to 5 grains. 

Hop relieves pain and calms irritation ; and since it is so very 
dangerous to give opiates to children, this hop may prove a good 
substitute for opium ; at least, it ought to be first tried. 

Of tincture of hop, give 5 or 6 drops, to children of two or three 
years of age. Of the yellow powder, called lupulin, 3 or 4 grains 
may be given in currant jelly. 

Iron is a very useful remedy ; and when given, in the proper ' 
cases, to pale, flabby children, it adds to the strength and comfort 
without causing any excitement. The wine of iron is as good a 
preparation as any for children ; of which a drachm may be given, 
two or three times a day, in water, to a child two or three years 
old ; but 2 or 3 tea-spoonfuls may be given, as the age increases 
on to thirteen or fourteen. 



MEDICINES FOR CHILDREN. 473 

The tartrate of iron, which has but little of the peculiar taste, 
and which is very soluble, is often given to children.' 

Chalybeate Powder. 

No. 202. Tartrate of iron and potash 2 grs. 

Aromatic powder 1 gr. " 

Sugar powdered 2 grs. 

Mix. 
Thrice daily. 

Iodine is a tonic, and may be administered to the youngest child. 
The tincture of iodine may be given, 5 drops in some sweetened 
water, only adding the sugar at the time of taking ; for else decom- 
position may ensue. Or the compound solution of iodine may be 
given to a child about seven years old, from 15 to 40 or more drops, 
in water sweetened with sugar, or syrup ; but the sugar must be 
added at the time of taking. 

There is a compound of quinine and iron which is very useful. 

The syrup of quinine and iodine is a powerful tonic. 

Ipecacuanha is expectorant or emetic, according to the dose. 
Half a grain or a grain, with sugar, every quarter of an hour, till 
it causes vomiting ; or 20 to 30 drops of ipecacuanha wine in like 
manner. After a year old, these doses may be doubled. A syrup 
of ipecacuanha is much used ; and an ounce of the syrup contains 
16 grains of the ipecacuanha, or an infusion is made by digesting 
2 drachms of the root in 4 ounces of boiling water, then adding 
sugar. 

One good formula is this : 

Emetic Mixture. 

No. 203. Water 1 oz. 

Ipecacuanha wine i oz. 

Simple syrup ^ oz. 

Mix. 

Of this, 1 or 2 tea-spoonfuls may be given, until vomiting comes on. 

This may be used when tartar emetic is forbidden by irritability 
of stomach or bowels ; and so far from increasing the action of the 
bowels, and causing exhausting motions, as tartar emetic is apt to 
do, it rather tends to restrain their action. 

When vomiting commences, usually in from fifteen to twenty 
minutes, or is about to commence, drinks should be taken to pro- 
mote the operation — barley-water, etc. 

When ipecacuanha is desired to act, as what may be called an 
alterative, very small doses are given ; to a child under two years, 



474 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

a twelfth of a grain may be given twice a day, with 3 or 4 grains 
of powdered gum arabic, the latter covering its nauseous taste, 
when the child is purged, or suffers from dysentery, or from full- 
ness of the head, or where the cough requires to be rendered loose. 
It probably acts by keeping up a slight nausea. 

When an overdose has been given, which may prove poisonous, 
give an infusion of nut-galls, which renders it inert. 

Jalaf. — This is an active, but not a very certain purgative ; 
given when the bowels are torpid and loaded, or when there a.re 
worms, or when the brain is attacked, as in water in the head. In 
this last case, calomel is usually added. 

The dose to a child under the year is about 2 grains ; and to 
those who are two or three years old, from 5 to 10 grains. When 
the liver or stomach is deranged, it is apt to disagree, causing vom- 
iting, griping, etc. 

It should be combined with ipecacuanha. 

No. 204. Powdered jalap 30 grs. 

Ipecacuanha 5 grs. 

Calomel 5 grs. 

White sugar 10 grs. 

Mix. 

Two to five grains of this every third hour. 

Jalap gingerbread for the nursery. 

No. 205. Flour 1 oz. 

Sugar 1 oz. 

Two eggs. 

Powder of jalap 60 grs. 

Mix. 

Of this mass, make three biscuits, and divide each into four por- 
tions. One of these to be taken twice a day. 

Liquor of Potash is useful in cutaneous eruptions, and for acid 
in the stomach or bowels. Three drops for a child two or three 
years old is the dose ; and it should be well diluted in barley- 
water, nor should it be taken beyond about three weeks at a time. 

The dose may be increased, as the age of the patient increases, 
up to 12 or 15 drops. 

Linseed, for diseases and irritations of the urinary organs. The 
infusion of linseed is made by pouring a pint of boiling water on 
6 drachms of linseed, bruised ; 2 drachms of bruised liquorice root. 
Let the liquid stand for four hours on a hob, and strain through 
linen or calico. 



MEDICINES FOR CHILDEEN. 475 

To render this more pleasant, though not more efficacious, we 
can add a drachm of lemon-peel, with its rind removed,'and a quar- 
ter of an ounce of sugar- candy. 

A wine-glassful now and then ; it relieves cough very much. 

Magnesia is perhaps one of the most valuable remedies we ha^e 
for children, who are much infested with acidity. The calcined 
magnesia should be used, because if it meets with acid in the stom- 
ach there will be no generation or evolving of carbonic acid gas, 
as may occur when the carbonate of magnesia is given. 

It should be combined with rhubarb. 

No. 206. Powdered rhubarb 20 grs. 

Magnesia 40 grs. 

Powdered cinnamon 10 grs. 

Mix. 

Three or four grains of this every third hour, to a child six months 
old ; from 6 to 10 grains after twelve months. 

Manna is a safe, gentle aperient, though it generally requires to 
be added to something else. 

No. 207. Tartarized soda 3 drs. 

Manna 3 drs. 

Dill water or cinnamon water 2 oz. 

Syrup of rhubarb or simple syrup. ... ^ oz. 

Of this, 2 or three tea-spoonfuls ; but to an infant under the year, 
1 tea-spoonful, repeated every three or four hours. For children 
of four or five years of age, the following lozenges : 

Manna Lozenges. 

No. 208. Cream of tartar i oz. 

Manna 4 oz. 

Water 10 oz. 

BoiLdown to a proper consistence, and divide into lozenges, weigh- 
ing 10 grains each. 

Mothers will find it worth their while to make these lozenges. 

Manna may be combined with senna, as in the following formula: 

No. 209. Infusion of senna 1 oz. 

Mint-water J- oz. 

Manna 2 drs. 

Magnesia 20 grs. 

Tincture of rhubarb 1 dr. 

Syrup of roses 2 drs. 

Mix. 

One or two tea-spoonfuls every third or fourth hour, until it acts. 



476 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Manna and syrup of roses, mixed in equal quantities, will be 
readily tal^en, and will often answer well. 

Niter, or Nitrate of Potash, is useful in many disorders of child- 
ren — in fevers, to lower the pulse and heat of system — in bleeding 
from internal parts, from the lungs especially. 

The following composition has been recommended as a very good 
remedy for gastric fevers or bowel disorders : 

No. 210. Dry carbonate of soda 8 grs. 

Ipecacuanha powdered 1 g^** 

Compound powder of ipecacuanha. . . 2 grs. 

Compound powder of cinnamon 6 grs. 

Nitrate of potash 10 grs. 

Mix, and divide into six powders. One to be given every third 
hour to a child a year old, in some barley-water or thin gruel. 

Inflammatory sore throat, where the little patient is unable to 
gargle, mix two-thirds of niter with one-third of sugar, and place 
a little of this upon the back of the child's tongue who is suff'ering 
from sore throat, two or three times a day. 

Opium is so badly borne by infants and young children, that 
mothers had better never attempt to give it, under any of its forms. 
Syrup of poppies, Dalby's carminative, Godfrey's cordial, paregoric 
elixir, are the ordinary forms under which opium has been given. 
The tincture of hop must be given instead. 

Mhuharh is an useful child's medicine. It combines an astring- 
ent and tonic with a purgative property, and it is, therefore, well 
adapted to the irritable bowels of children. In inflammatory com- 
plaints, or where there is excitement, we should not give rhubarb ; 
thus it should not be given in the early stage of dysentery, though 
it is of great benefit in the later stages. When combined with 
magnesia, it relieves the griping complaints of children. 

For a dose to a child six months old, two grains may be given, 
with as much calcined magnesia; to a child two years old, five 
grains may be given in dill water, or mint, or aniseed water. But 
a late writer says the syrup of rhubarb, with a little dried soda or 
magnesia added, will be readily taken by young children. 

It is most efi"ective when given in powder ; but its taste can be 
best disguised in the form of infusion, to which some cinnamon 
powder has been added, and also camphor julep, for camphor in- 
creases the action. This infusion is made by macerating (letting 
stand in a gentle heat) for two hours half an ounce of powdered 



MEDICINES FOR CHILDREN. 477 

rhubarb in nine ounces of boiling water, with one scruple of cin- 
namon ; then to strain it through linen or calico. 

The dose of the syrup to an infant is from half to a whole tea- 
spoonful. 

Gregory's 'powder consists of two parts of rhubarb, four parts of 
calcined magnesia, and one part of ginger, well mixed and rubb'ed 
together. 

Salts^ or Epsom salts, act mildly and quickly. The child should 
be made to drink pretty freely soon after taking the salts ; not 
too soon, however, lest from over-distension the stomach reject 
the medicine and drink together. Wait half an hour, and then 
give drink. The more diluted the salts, the more effectively will 
they act. 

Dose. — To children about three and a half or four years old, a 
drachm of Epsom salts may be given in water, sweetened with 
syrup of lemon-peel ; or they may be given in the compound infu- 
sion of roses, sweetened. 

Sarsaparilla. — This is an auxiliary in the treatment of depraved 
conditions of the system, in eruptions on the skin, and in disor- 
ders of the digestion, though many deny that sarsaparilla does much 
or any good. 

Dose. — A tea-spoonful of the fluid extract may be given two or 
three times a day, in some water, to a child five years old. 

Senna. — This is one of the most common aperients in use, and 
produces a decided though not a violent impression. It seems to 
remove mucus accumulations from the stomach and bowels, and 
thus may be useful in worm cases. The best combination is with 
manna, tartrate of potash, and aniseed or dill water. Pimento 
water hides the taste best, and tincture of orange-peel will also 
disguise the flavor. 

Or, we may digest a drachm of senna leaves in a sufiicient quan- 
tity of cold water for a night, and coffee is prepared in the morn- 
ing with the strained hquor. A purgative is thus obtained devoid 
of all nauseous taste. 

An infusion is made by pouring eight ounces of boiling water 
over one drachm of senna leaves, and a few prunes digested in it. 
Of this a table-spoonful or two operates well. 

Epsom salts are often wisely added to the senna. 

Sulphur has an action over the skin, and over the large and 
lower bowel (the rectum). It is a laxative, promotes perspiration, 



478 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

and acts gently. It is given in piles, prolapse or coming down of 
the lower bowel, in long-standing eruptions of the skin, and it is 
a popular remedy for rheumatism. 

A friend of the author puts some sulphur under the soles of his 
feet when troubled with the rheumatism, and he speaks with enthu- 
siasm of the good effects. 

Dose — is thirty grains to one hundred and twenty to a child six 
years old ; the precipitated sulphur is preferred, and it is to be 
given in milk, combined with half the quantity of cream of tartar. 
' Sulphate^ or Super-sulphate of Potash, is useful in disorders of 
the liver and bile ducts, and it is a purgative. It is usually given 
combined with rhubarb — thirty grains of the sulphate with ten of 
rhubarb, in any aromatic water. 

Scanvmony is at times required when there is much mucus in the 
bowels of children, to which they are a good deal exposed. It is 
apt to gripe and irritate ; wherefore it must be finely powdered, and 
combined with some aromatic. Worms are dislodged by it sooner 
than by any other drug; but its high price leads to its frequent 
adulteration. 

No. 211. Powdered scammony 30 grs. 

Prepared chalk , . . . 15 grs. 

Aromatic powder 5 grs. 

Mix well. 

Two grains to five every three or four hours. 

No. 212. Rhubarb ^ 

Scammony v equal parts. 

Sulphate of potash ) 

Aromatic powder should be added. 

The carbonates of potash or soda are often useful, combined with 
other remedies ; three or four grains for a dose. 

Aloes, for the thread-worm, or to relieve the head when threat- 
ened, may be given. Liquorice root disguises the taste. 

No. 213. Compound decoction of aloes IJ- oz. 

Liquorice root 2 drs. 

Wine of aloes 2 drs. 

Mix. 

One or two tea-spoonfuls twice or thrice daily. 

Suppository of Aloes, 
to be introduced into the lower bowel when irritated by thread- 
worms : 



CASTOR-OIL BISCUITS— TEETHma. 479 

No. 214. Powdered aloes i oz. 

Common table-salt 3 drs. 

Flour 2 drs. 

Honey enough to make a mass. 

An useful Purgative Injection, 
to help in costiveness^ and to prevent the necessity of giving many- 
aperients by the mouth, is the following formula : 

No. 215. Barley water 5 oz. 

Common table-salt 3 drs. 

Olive oil J- oz. 

Mix. 

To this, if much wind in the bowels be present, add one or two 
tea-spoonfuls of spirits of turpentine. 



Castor-oil Biscuits. 

Take a quarter of a pound of flour, two ounces of moist sugar, 
a small quantity of mixed spice finely powdered, and, with an ounce 
and a half of castor-oil, make the whole into the consistency of pie- 
crust, to which may be added a few currants ; roll out the paste and 
divide into ten cakes, and bake over a quick oven. Each cake will 
contain more than a tea-spoonful of oil. By adding molasses and 
ground ginger, the same may be made into gingerbread nuts. Sev- 
eral families find these cakes useful. 



Diseases oe Children. 
Teething. 

The evolution of the first set of teeth is a perfectly natural pro- 
cess, but it is occasionally rendered both painful and difficult by 
errors in the management of the infant ; and then it becomes the 
most critical period of childhood ; and thus it is we hear that, out 
of 1,000 children born at the same time, 257, or more than one- 
fourth, will be dead at the close of the first year ; while of the 
remaining 743, but 118, or less than one-sixth, will be dead at the 
close of the second year. 

Into the causes of this mortality we need not here enter; but 
one very efficient is the process of dentition, which, in some scrof- 
ulous and irritable habits, excites fatal convulsions in a certain 
proportion of cases. 



480 



AMERICAN HOUSEHOLD BOOK OF MEDICINE, 



The order of cutting the teeth is this : the two middle teeth, the 
incisors of the lower jaw, appear first, about the seventh month; 
the corresponding incisors in the upper jaw follow in about three 
or four weeks, and then the remaining four incisors in the upper 
and lower jaws. The two canine teeth then appear, first in the 
lower jaw, then in the upper. Soon after these, the grinders ap- 
pear in the same order — one on each side, first on the lower jaw, 
then on the upper. At the end of from four to six years, four 
more grinders appear in each jaw; these are permanent, and grow 
with the increase of the body. At the age of twenty-one, or later, 
four more teeth appear, called the wisdom teeth; thus, in all, mak- 
ing thirty-two teeth in the adult. 

The numbers in the following table show the succession of the 
teeth ; the numbers do not refer to months or years : 



Molar 
Teeth. 


Canine. 


Incisors. 


Canine. 


Molars. 


Upper Jaw. 
Lower Jaw. 


9 


5 


7 


3 


2 


2 


3 


■ 7 


5 


9 


10 6 


8 


4 


1 


1 


4 


8 


6 


10 



The temporary or deciduous teeth appear, on an average, at the 
following periods after birth : 

The central incisors at about 

Lateral incisors from 

Anterior molars " 

Canines " 

Posterior molars " 

Permanent Teeth. 

The first molar from 

Central incisors 

Lateral incisors 

First bicuspid 

Second bicuspid 

Canines 

Second molars 

Third molars 

Many children do not suffer at all during the whole process of 
teething; others are afilicted with convulsions, heat, and excite- 
ment ; others with looseness of the bowels ; and these last do best. 
In some, slavering exists for some time, more or less ; in others, 
there are no precursory symptoms at all. 



Months. 


Months. 

7 


8 to 


10 


12 " 


13 


14 " 


20 


18 " 


36 


Tears. 

61 to 


Tears. 
7 


7' " 


8 


8 " 


9 


9 " 


10 


10 " 


11 


12 " 


12^ 


12i " 


14 


16 " 


30 



TEETHING. 481 

The convulsions are often fatal ; but as thej proceed from or 
depend upon, the delicate vascular and highly-sensitive membrane 
which surrounds the tooth being put upon the stretch, much may 
be done by a watchful mother to prevent convulsions and every 
danger. 

Fever also may attend teething ; and heated hands, flushed face,'* 
offensive urine, and flushing of the cheeks attest the sympathetic 
irritation which is set up. The gums may become red, swollen, 
and hot ; diarrhea, swelled glands, sore eyes, a croupy cough may, 
in different cases, prevail. 

Pure air, tepid bathing, care as to diet, and free bowels are to 
be procured if possible. The tepid bath, at 95°, is very soothing. 

The child may mumble a hard crust, though, as a little bit of 
hard crust sometimes gets detached, and slips down the throat, 
causing cough, it would be better to let the child mumble the coral, 
ivory, and other contrivances, on sale for that purpose. 

The mother or nurse should gently rub the gums where they are 
swelling. 

If the bowels are too loose, four grains of the compound chalk 
powder, just to restrain within bounds, not to arrest ; if they are 
confined, four or five grains of Gregory's powder, with three or 
four drops of sal volatile. 

Should this treatment fail, then lance the gums well down to the 
tooth, again and again, if necessary ; and no fear need be enter- 
tained of the scar from the lancet or sharp knife, or sharp edge 
of any kind, becoming hard and resisting the forthcoming tooth. 

All newly-formed parts, such as scars or cicatrices, are sooner 
absorbed than the original structure. 

This lancing, immediately a convulsive fit is threatened, has been 
successful many times, pretty nearly uniformly so. 

The fever and irritation, wherever they manifest themselves, 
must be treated on the principles laid down in preceding pages, 
only adapting the number of leeches, and amount of depletion or 
lowering, to the degree of fullness in the vessels which may exist. 

If the gums ulcerate, a little alum or borax, in honey or syrup, 
smeared over the ulcer, with an aperient or two, and a cooling diet, 
will soon cure. 

If the jaws are not expanded enough for the permanent teeth, 
or if the teeth are too large, a well-educated dentist should be con- 
sulted ; also, if any make their appearance in the wrong place. 
31 



482 AMERICAN HOUSEHOLD BOOK OF MEDICINE 

Scrofula. 

This peculiarity of constitution demands the utmost care and 
attention; for while it spares neither age, sex, nor condition, its 
attacks and progress are often so insidious, that disorder and dis- 
ease may have fixed their roots in the constitution before alarm is 
taken. 

For instance, scrofulous inflammation is a very slow process in 
many instances ; and if matter is formed, it is formed slowly ; and 
the pus formed is not like the ordinary matter in other inflamma- 
tions ; it is not one fluid ; homogeneous is the technical term. It 
consists of a thin, serous, whey-like fluid, and partly of fragments 
resembling curd. The ulcers left are indolent, will not readily 
yield to remedies, nor will they readily heal up. 

This temperament is well known by certain marks, viz. : an ex- 
treme whiteness and fineness of the skin, fair hair and blue eyes, 
a soft and rounded form of the body, the cellular tissue of which 
fills up all lines and muscular or other projections ; there is a look 
of perfect health; yet, though the skin and bodily substance ap- 
pear firm to the eye, they are soft and flabby to the touch ; the 
countenance, generally full and rounded, conveys an expression of 
softness ; the cheeks often beautifully colored ; the teeth white in 
a remarkable degree ; the lips are apt to be swollen, especially the 
upper ; the nostrils swollen, and the skin is easily irritated by what 
would not cause irritation in a sound person. In some children 
with this temperament, even mild-scented soaps have sufficed to 
cause an eruption of pimples. 

The intellect in early life is active, vivacious, and cheerful, and 
the moral and mental faculties are of a pleasant cast; but there is 
a want of firmness and solidity. Such children are clever, and 
exceedingly quick in learning any thing they try to conquer ; their 
parents are delighted with them, and wish to incite them to con- 
stant intellectual exertion, whereby disease is often roused into 
action, never again to quit the patient. 

Scrofula is also common in those of a very difl'erent tempera- 
ment—the melancholic or bilious. Then the complexion will be 
dark, the countenance swollen and pasty, the habit indolent, and 
the functions of the body are performed sluggishly, and perhaps 
imperfectly ; the nervous energy is feeble, the feelings obtuse, and 
the moral and intellectual powers occupy a low rank. 



SCROFULA. 483 

The late Dr. Thompson tells us that the worst forms of scrofula 
occur in persons of this temperament. 

Scrofula consists, essentially, in the formation and presence in 
the various tissues of tuberculous matter. It may affect, though 
with various degrees of frequency, almost every tissue in the body, 
the susceptibility varying with the age of the individual. 

Childi'en most frequently suffer from scrofula in the glands of 
the neck, in the mucous membranes, and in the mesentery (a 
membrane by which the bowels are fastened to the spine). 

Scrofula as it affects the Glands of the Neck. 

These are seldom so affected in children under two years of age, 
and the period of life most exposed is between the fifth year and 
puberty. 

An eruption on the scalp, or behind the ears, may be complained 
of; then the glands swell, and feel firm and fleshy to the touch. 
By degrees the glands become larger and harder, though slowly, 
parts of them being as firm as cartilage ; then a process of soft- 
ening takes place in particular spots, which, if then examined, 
would be found to contain a soft, yellowish-white, and cheesy tu- 
berculous matter. Some curdy, yellowish pus or matter is formed, 
which slowly makes its way to the surface, sometimes through sev- 
eral apertures, when an open scrofulous abscess results. 

These glands may attain a large size, continuing hard ; and 
might even be absorbed without matter forming, if the health hap- 
pened to improve. 

An open scrofulous abscess discharges, for a long period, a thin 
fluid, containing curdy flakes, and now and then small masses of 
tuberculous matter. 

The sore itself is characterized by a thin, overhanging, livid 
margin, with pale and flabby or indistinct granulations ; and it 
sometimes heals in one part to break out in another. 

Scrofula often attacks tRe ears of children, the outward passage. 
The membrane is inflamed, progressing slowly ; then pustules are 
formed, with a discharge of unhealthy, badly-smelling matter. 

Now, this inflammation may extend into the ear, causing ulcera- 
tion of the membrane of the drum of the ear, when deafness would 
result; and it may extend further in toward the brain, causing 
disease of the brain and death. 



484 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Scrofulous discharges from the vagina, of a purulent or muco- 
purulent character, are not unfrequently met with, and will only 
yield to those measures which tend to improvement of the general 
health. 

Scrofula does not appear to be the direct product of any pecu- 
liar virus, as direct attempts to propagate it by inoculation have 
been unsuccessfully made by several. 

The marks by which we recognize the scrofulous tendency, are 
all such as denote the preponderance of the white tissues and fluids 
of the body over the red ; that is, of the lymphatic over the arterial 
and venous systems. 

Now, all we know of physiology teaches us " that the strength, 
vitality, and capability of resisting disease possessed by animals 
(at least warm-blooded animals), is in a direct ratio with the pre- 
ponderance of the red tissues and fluids in their bodies over the 
white ; that, in fact, the white tissues have naturally a lower de- 
gree of those qualities than the red ; and the more they abound in 
the system, in relation to the others, the less power will there be 
for resisting morbid conditions." 

External causes seem to have a power of exciting scrofula in 
persons who do not show any of the marks of the scrofulous ten- 
dency ; and they act by favoring the production of the white over 
the red tissues — for instance, confinement in damp, unhealthy situ- 
ations, with diminished supply of light and air. Thus inhabitants 
of cellars, and of houses without good air, and with very little 
light, will become scrofulous. 

Parrots, monkeys, rabbits, etc., all die of consumption when 
taken and put into confinement, after constantly living in the open 
air, and under a brilliant sun. 

Peculiarities of structure have a tendency to be communicated 
from parent to offspring ; and we should confidently expect that 
the deficiency in red tissues, so conspicuous in the scrofulous tem- 
perament, would be bequeathed by a strumous father or mother 
to their child; and we find that it frequently so happens. For- 
tuitous circumstances may originate sorofula in those not predis- 
posed, and a generation may be passed over without any attack, 
in consequence of better air, living, and exercise having engen- 
dered a healthy predominance of the red tissue over the white. 

Scrofula may be attended with a deposit of tuberculous matter ; 
or, again, there may exist scrofula in various parts without any 



SCROFULA. 485 

deposit of tuberculous matter. The seat of this last is the mucous 
system, and not the cellular, as was long believed. The mucous 
systems require for the discharge of their functions a large share 
of red blood, and a high degree of vitality ; they will, therefore, 
suffer soonest, and most severely, from any minus state of the 
constitution in these particulars. 

The preventive treatment of scrofula is very important, and 
this is to be done by endeavoring to restore the deficiency in the 
red fluids and tissues, by paying attention to the various items 
concerned in the management and bringing up of children. To the 
chapters on Food, Clothixg, etc., the reader may turn for direc- 
tions how to proceed. 

There are three points which require to be specially attended to 
in the prevention of scrofula : 

1st. Where a taint of the disease evidently exists in the mother, 
that the state of her health during the period of pregnancy should 
be regarded with the most jealous care. 

2d. That on the birth of the child, if either parent should have 
strumous or scrofulous predisposition, preventive means must be 
resorted to during the early years of life. 

3d. In cases where there is no hereditary predisposition, but 
locality or other external agents appear the source of the disease, 
these must be obviated. 

Females are not sufficiently aware of the influence exercised by 
their own state of health, during pregnancy, on the offspring they 
are carrying. Every sensible woman may safely trusi to her com- 
mon sense for the avoidance of errors in diet, clothing, etc., only 
she must be watchful. Some cautions apposite to this purpose 
will be found in preceding pages. 

When the child is born, and the father only be of a strumous 
habit, the mother may be permitted to suckle her child ; but if the 
mother be scrofulous, then a wet nurse should be obtained ; and a 
right or wrong choice of a wet nurse may exercise a baneful in- 
fluence on the whole future life of the child. 

About the age of ten or twelve months, the child should be 
weaned, because protracted lactation tends very strongly to pro- 
duce a feeble habit of body. The milk, after twelve months, be- 
comes poor and innutritious, giving rise often to flatulence and 
indigestion. 

The food should now consist of cow's milk, with light nutritious 



486 AMERICAN HOUSEHOLD BOOK 0"F MEDICINE. 

« 

vegetable food and a little broth. Fatty matter in milk is recom- 
mended by Dr. Paris. The suet is to be inclosed in a muslin bag, 
and so simmered with milk ; and this affords much nutriment in a 
little space. This has been compared to goat's milk, but it is more 
astringejit ; it has been strongly recommended in atrophy, or scrof- 
ulous decay, and was very useful when every other article of diet 
caused irritation in the bowels. As children have not the temper- 
ature so high as that of adult age, and as they do not enjoy the 
power of generating heat to the same extent, the clothing, there- 
fore, must be warm, and effectually protect against the vicissi- 
tudes of the weather. Exercise in the open air; living in well- 
aired, spacious apartments ; tepid baths or cool baths may also be 
put in requisition. 

As the child grows up, and particularly if the intellect is pre- 
cocious, parents must be warned against allowing such children to 
work too much with the head. Disease is soon set up of an in- 
sidious character ; and the child is attacked with tubercular inflam- 
mation of the brain, which too often bids defiance to all remedies. 
I could relate many instances of the fatal results from neglecting 
this point of treatment. 

Childhood is the period of groivth, and the full exertion of the 
intellect should be kept in the background ; for any undue exertion 
of the mind can only be carried on at the expense of the bodily 
powers ; and it has been justly observed that " eventually the hopes 
derived from precocious intellect are disappointed, and that state 
of intellect -^ich should only have been the accompaniment of 
after and more mature years, fades into weakness and irresolution 
as manhood advances — that very period of life when the independ- 
ence of intellect is required. A child with a scrofulous tendency 
should learn its lessons in the fields, and not be bound down to books 
in the crowded atmosphere of a school-room." Boys are better 
treated than girls, for they have their hours of exercise and free 
enjoyment; but female education is fraught with conditions the 
most obnoxious to the strumous, in the shape of ill-ventilated and 
confined rooms, of the use of stays, bands, and strings, and in a 
system of driUing and exhausting attention, either to mental or 
bodily qualifications. One would imagine that all parents would 
not need any words of warning, yet the physician is continually 
meeting with lamentable instances arising from neglect of these 
sanitary rules. 



SCROFULA. 487 

In those cliildren who have imperfect appetites and digestion, 
and whose bodily powers are weak, I have often prevented mis- 
chief by recommending the use of some of the chalybeate waters, 
or of a syrup composed of the citrate of iron, two grains to the 
ounce of syrup, and a tea-spoonful given, twice a day, in some 
water; or, if the syrup disagree, a little tincture of orange-peel, 
about two drachms to three-quarters of an ounce of water, and 
two grains of the citrate of iron, in the same doses, have done 
great good, a gentle aperient being occasionally given. The tone 
of the whole body has thus been strengthened, and all deposits of 
a morbid nature prevented. 

The following is an instance of the prejudicial effects of cold at 
school. A young lady, aged fifteen, had just begun her periods, 
and was rapidly developing into womanhood, with every appear- 
ance of very good health. She was sent to a finishing school, and 
in about three months I was sent for, and found her in a state of 
rapid consumption, which bid defiance to all treatment, so general 
was the disposition of tuberculous matter throughout the lungs. 
The only cause I could discover for this fatal change, was found 
in the fact' that every morning, during the winter season, the suf- 
ferer had to practice at the piano-forte, from seven to eight o'clock, 
in a large, cold room, without fire. The poor girl felt, she said, 
almost frozen every morning, and never recovered any warmth dur- 
ing the whole day. Thus the blood, driven from the surface of the 
body, caused congestion and slow circulation in the lungs ; and a 
general deposit or infiltration of tuberculous matter took place. 

Another striking exemplification of the danger"" arising from 
neglect of proper warm clothing, and the consequent imperfect 
performance of the very important cutaneous functions, was related 
to me by a medical friend, who, many years ago, accepted an ap- 
pointment as family physician to an English lady of rank, who 
was married to a Russian nobleman. After residing some time at 
St. Petersburg, he found the lady had some fixed opinions about 
the physical education of children, and that she was firmly per- 
suaded that bringing them up on the hardening system, as it used 
to be called, was the only way to make them grow in vigor. The 
author's friend, who was a clever and well-educated physician, ex- 
plained to her that the system she so much affected required modi- 
fications, according to the peculiarities of different constitutions. 
Some will bear, and bear it well, too, an amount of cold that 



488 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

would soon kill others. Now this lady had a daughter, about 
thirteen or fourteen years of age, in pretty good health, but with 
the fair skin and other marks of scrofula, whom the mother would 
always send out into the air with a very insufficient amount 
of protective clothing, notwithstanding the doctor's earnest and 
then somewhat angry remonstrances, who, at last, finding he was 
not allowed to direct all matters pertaining to health, resigned his 
appointment. In one short year the poor girl was hardened into 
her grave. 

The danger from scrofula generally passes away after the age 
of puberty, or about twenty-one, unless in the case of consump- 
tion. 

Treatment. — If we remembers the causes, both predisposing and 
exciting, of this malady, we shall have no difficulty in making out 
what we are to aim at in our attempts at cure. 

To improve the general health is the first point, and this must 
be done in every possible way ; and to promote the dispersion of 
local tumors is the second. 

A nutritious diet must be secured ; but great attention must be 
paid as to the quantity and quality of food admitted into the stom- 
ach of those of scrofulous habit, who are ready to suffer disease 
more quickly than others. Whenever strumous children are suffer- 
ing from bowel irritation, as in atrophy, indigestion, etc., animal 
food had better be withdrawn for awhile, and a farinaceous one sub- 
stituted, or else a diet adopted which is modified between the two. 

In the article Indigestion, I have explained that the food is 
digested in proportion to the quantity of gastric juice secreted, 
and that the quantity of this secretion depends on the want in the 
system for food and support. Give more than that proportion of 
food demanded by nature, and irritation arises, to end in disease, 
perhaps. 

Warm clothing is quite indispensable; and during the cold months 
there should always be sufficient blankets to the bed, to prevent any 
feeling of coldness. It must, however, be borne in mind that we 
must not make the child wear so many clothes as will keep the 
skin in a strongly perspiring state, for that would be to exhaust 
the strength. The skin should be maintained in just such a per- 
spirable state as will keep it soft and pliant to the touch. Flannel 
or woven cotton may be worn. 

Exercise, in a dry, bracing air, must be regularly taken. Bath- 



SCROFULA. 489 

ing in sea-water, and at the seaside, is very useful. Some medical 
men object to the seaside in cases of consumption ; but it has been 
explained why and in what cases the sea bathing and sea air may 
disagree. 

My practice is to order all who consult me to stand or sit in a 
tub of water, as hot as can be borne comfortably; then, with a flan-" 
nel, and the best soft soap — scented, if it be preferred — to have 
the whole body first sluiced with the water, then soaped down from 
nape of neck to sole of the foot, then wiped dry, and, finally, a 
bucketful of tepid water, or water nearly cold, may be throvfn over 
and down the body and limbs, which are to be wiped dry before 
getting into bed. This may be repeated two or three times a week ; 
and such is the comfort derived from the practice, so speedily and 
sensibly beneficial are the effects, that no recommendations are 
needed to continue the practice. 

Every pore of the skin is opened, and all adherent scales or dirt 
removed ; and there is little doubt of such ablutions having high 
protecting power against disease. 

For some years I used the hot water and soap, but latterly I 
find the final bucket of cool or cold water a very powerful tonic ; 
and so tranquilizing is the influence that the following night is 
passed in one untroubled sleep. 

The iodine baths have been strongly recommended, and they 
certainly do determine strongly to the skin, hands, and feet, etc. 

Lugol's formula for iodine baths to children between four and 
seven years of age is this : 

No. 216. Water 36 quarts. 

Iodine 30 to 36 troy grs. 

Hydriodate of potash 60 to 72 troy grs. 

Strumous children often complain bitterly of cold feet ; and many 
a school-girl has been prevented from getting any sleep by the cold- 
ness of her feet, or, it may be, by chilblains. 

Here the iodine pediluvium is of service. A solution of iodine 
should be kept ready to add to the water. 

Iodine Foot-hath Solution. 

No. 217. Purified iodine 60 grs. 

Hydriodate of potash 120 grs. 

Alcohol 2" ^2i. 

Distilled water 3J oz. 

Mix. 



490 AMERICAN HOUSEHOLD BOOK OE MEDICINE 

A table-spoonful of this solution to enough hot water forms a 
foot bath ; to be used every night or alternate night. 

In some cases, I found there were complaints of the bath leaving 
behind it a troublesome itching, to remove which a couple of grains 
of cjanuret of potash may be added to each bath. 

The shower bath, warm or tepid at first, may be found beneficial. 

Aperients occasionally must not be forgotten ; gray powder, with 
powdered rhubarb, with one or two tea-spoonfuls of castor-oil, next 
morning, will suffice. 

If indigestion accompany, with acid, heartburn, etc., the carbon- 
ates of magnesia, potash, or of soda may be given, two or three 
times a day, in some bitter infusion, so long as the state of indi- 
gestion continues. 

Tonics are very beneficial, and those derived from iron are the 
most desirable. The ammonio-citrate, or the citrate, as it is com- 
monly called, is the best for children, both because it is less disa- 
greeable to take than any other of the chalybeates, and because 
alkaline carbonates may be combined with it, if necessary. 

It may be taken in a state of efi"ervescence, by dissolving ten 
grains of the sulphate of iron in some water — a wine-glassful ; then 
dissolving in some water, in another glass, ten grains of the sesqui- 
carbonate of soda. Syrup of orange-peel, etc., may be added to 
taste. On mixing the two, we shall obtain a solution of about four 
grains, of carbonate of iron, two and a half grains of sulphate of 
soda, and five grains of sesquicarbonate of soda. 

The chalybeate waters are, perhaps, the best vehicles for this 
kind of tonic ; for the metal is so finely divided, and the quantity 
taken is so small, that no irritation can possibly, or ever does, en- 
sue ; provided the proper case has been selected. 

A gaseous chalybeate water can be thus made : 

No. 218. Bicarbonate of soda 98 parts or grs. 

Tartaric acid 116 grs. 

Sulphate of iron 3 grs. 

White sugar 280 parts or grs. 

Mix well by rubbing, and keep the resulting powder quite dry, in 
a well-stoppered bottle. This quantity will make a quart. 

In some cases the iron and quinine ought to be combined ; and 
there are preparations sold of the two rubbed in together. 

In enlarged or hardened glands, the iron should be combined with 
iodine, and the syrup of iodide of iron should be perseveringly 



ENLARGED GLANDS. 491 

given, beginning always with very small doses, until the stomach 
can well bear larger ones. 

The cod-liver oil is one of the most valuable medicines in scrof- 
ula we can possibly give ; and though it acts rather as an agent of 
nutrition than as a remedy, still it certainly does a vast amount of 
good. The iodine in it contributes to the beneficial effect. 

The iodide of potash, in bitter infusion or with sarsaparilla, has 
been much lauded, but I do not often give it; and neither this 
iodide nor iodine should ever be given under certain circumstances ; 
namely, when there is a tendency to too profuse periods, or when 
there is an erysipelatous state of the skin ; and inflammations of 
the lungs, or irritation of the stomach or bowels, or diarrhea also 
forbid its use. 

When it is doing good, the almost immediate effects are an im- 
proved appetite, a more healthy color of the skin, which are often 
followed by decrease of swelling and absorption of the disease of 
the glands. And we shall know when to leave off the iodine — 
when a feverish state suddenly appears, a headache, loss of appe- 
tite, etc. ; for if we continue the iodine, a quick pulse, palpitations, 
dry and frequent cough, night-watchings, rapid thinning, loss of 
strength, trembling, etc., will give undoubted evidence of the mis- 
chief which the iodine is effecting in the system. 

Enlarged Glands. 

Besides the above general measures of treatment, the local ap- 
plication are of importance. The best application is, to paint once 
or twice a day, by means of a camel-hair brush, the enlarged glands, 
with a solution of pure iodine in alcohol — ten to thirty grains to an 
ounce of alcohol. 

If the glands inflame more under this application, discontinue, 
and apply cold or warm poultices till the redness disappears ; then 
paint again. 

Sometimes an ointment of iodide of lead agrees better, sixty 
grains to an ounce of lard. The ointment of zinc is very useful 
at times. 

If passages called sinuses form, inject a weak solution of iodine, 
five grains to an ounce of alcohol, and apply pressure above th& 
passage. These sinuses are often intractable. 



492 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



Scrofulous Ear. 

Cleanliness is what is here chiefly wanted ; and we may relieve 
the irritation in the auditory passage by exciting counter-irritation 
behind the ear. This is done by placing a piece of woolen thread, 
smeared with bHstering ointment, in the angle between the ear and 
skin of the head, or by an eruption caused by the tartar emetic 
ointment. 

Rickets — ^Rachitis 

commonly appears about the first dentition, or it then begins to 
show its first symptoms, when the child has to try and supptort the 
weight of its body upon its limbs. 

Symptoms. — The general health first shows signs of derange- 
ment ; the child becomes languid, feverish, the skin dry and rough, 
the flesh soft and flabby ; countenance pale ; appetite uncertain, 
and depraved sometimes ; the digestion is impaired, the bowels ir- 
regular, the stools and urine unhealthy-looking, the abdomen or 
belly jutting forward, though this last symptom may depend on the 
bones of the spine, in the loins, jutting forward too much, in which 
case the hollow of the back will be unnaturally concave. With 
all these there is more or less of fever, not unlike the remittent 
fever. 

After a time the head begins to enlarge, and the openings in the 
head of the infant do not close at the proper time. 

The ends of the long bones at the wrists and ankles swell into 
knobs, which appear all the larger from the shrunken state of the 
limbs. The bones become soft and incapable of supporting the 
weight they should do ; the legs bend, the chest narrows, and the 
breast-bone projects forward. 

The hip-bones participate in the deformity ; and the teeth come 
forward very slowly, and sufi*er speedy decay. 

The impression is general that rickety children are of precocious 
intellect, but this there is reason to doubt. 

This disease depends upon a deficiency in the earthy matter of 
the bones. Dr. John Davy found that 100 parts of the tibia (large 
bone of the leg) of a healthy subject of fifteen yielded 46.4 of ani- 
mal matter, and 53.6 of earthy, while the same quantity of the dry 
tibia of a rickety child contained 74 parts of animal, and 26 of 
earthy substance. 



RICKETS— RACHITIS 498 

Rickety persons are seldom long-lived, and many suppose that 
phthisis is brought on ; but the chest symptoms, of great expector- 
ation and dyspnoea (difficulty of breathing), are occasioned by the 
deformity of the chest, which at length impedes the passage of the 
blood from the right to the left side of the heart. 

The causes are the same as those which favor the induction of 
scrofula. Any thing which prevents healthy nutrition may bring 
on rickets ; so, if the causes can be removed, and the disease is not 
too far advanced, we may hope to cure or to arrest the progress 
of rickets. 

The greatest dangers arise from the great deformity of the chest, 
and from any fevers or exhausting diseases attacking the rickety 
child, which is all the less able to bear the strain of the added dis- 
ease. 

Treatment. — This is comprised in that of Scrofula ; and all we 
have to add here is, as to managing the child's positions ; for any 
undue pressure upon any part, and especially the chest, must be 
avoided; the bones are so flexible that pressure carelessly con- 
tinued in the same situation, will be very likely to alter their 
shape. 

Dupuytren used to place the child with a deformed chest from 
rickets with its back against a flat, resisting body ; and then press- 
ing with the extended palm of the hand upon the chest-bone, so as 
to flatten the chest from before backward, and increase the con- 
vexity of the ribs. By frequent daily repetition of this pressure, 
more may be done to correct deformity than would be imagined ; 
and the nurse could do it, only force sufficient to cause pain should 
never be used. 

All instruments for straightening the spine, etc., are here use- 
less,, and, indeed, they are prejudicial, by impeding or preventing 
the muscles from acting. Instruments, too, must bear upon some 
points for support. Now, in rickets the hips will give way all the 
sooner for any extra pressure being put upon them. 

Some padded splints may here and there be applied, but even 
these will require great caution and judgment. 

In the case of Madam Supiot, it is related that she could, and 
often did, place her legs at her sides, and on parallel lines with 
her body. 



494 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

AtrophY' — Mesenteric Decline. 

This may arise from disease of the mucous membrane of the 
bowels, either irritation or inflammation, or it may arise independ- 
ently in a child of highly scrofulous habit. The mesenteric glands, 
which are scarcely perceptible at birth, undergo gradual develop- 
ment until about the period of dentition, when, in common with 
other parts of the glandular system, they begin actively to enlarge ; 
and, accordingly, we find that disease of the mesenteric gland 
makes its appearance about this period. Infants are seldom af- 
fected before the eighth month ; but from that time to the eighth 
or tenth year the disease is liable to occur ; most frequently from 
the third to the sixth year, or about the seventh. The glands of 
the mesentery are more subject than any others to tubercular dis- 
ease. (See Secretions.) 

These glands may first begin to swell from irritation set up in 
the bowel, and they may remain in an indolent state for some 
time, being in size not larger than a pea ; but they may increase in 
quantity until they arrive at considerable size, resembling a heap 
of peeled chestnuts. They become soft, and contain a soft, white, 
curd-like matter ; and this matter is sometimes found in consider- 
able quantity, not only in the gland, but around it, or within the 
layers of the membrane. 

Symptoms. — Progressive loss of flesh unto extreme emaciation 
may be said to be the chief feature of this disease. This wasting 
is not invariably present, for tubercles have been found in the mes- 
entery where there had been no wasting ; still, w^asting is rarely 
absent ; and it has been attributed to a failure of nutrition, caused 
by actual obstruction to the passage of the chyle through the 
glands ; this is, however, an error, for the glands have not been 
found impervious to injections after death ; nor would the patient 
last so long as he does if obstruction were the cause acting. ISTo, 
the sufi'erer is generally cut off, rather, from some acute attack, 
or from hectic fever; for so long as the glands remain indolent the 
emaciation does not become remarkable ; but when they soften, 
and begin to suppurate, hectic fever sets in, and emaciation rapidly 
ensues. The digestive organs are also in a state of irritation, and 
digestion is much interfered with. 

The wasting in this disease is regular and slow; that from bowel 
complaints is rapid and variable. 



ATROPHY— MESENTERIC DECLINE. 495 

The symptoms of disorder of the mucous membrane of the bowels 
so much resemble and are mixed up with those of atrophy, that a 
distinction can not well be set up. The only unequivocal evidence 
of this atrophy, is the feeling the glandular masses in the abdomen. 
Still, there is a combination of symptoms which will indicate, viith 
some probability, what is going on in the abdomen, and vfhether 
the morbid state is one of irritation of the mucous membrane or 
one proceeding from this tuberculous or scrofulous state of the 
mesenteric glands ; it matters not as to treatment, for what will 
suit the one will also suit the other. 

These symptoms may be divided into three periods or stages. 
First, the incipient stage, or that in which the enlargement of the 
glands is present, but has not made itself manifest by disturb- 
ing the general health, or deranging the digestive organs in any 
marked manner; second, a stage of further advancement, when 
the glands of the mesentery have become perceptibly enlarged, 
and the derangement of the digestive organs decidedly marked. 
This is the period at which the stools are observed to assume the 
white color, which they so frequently exhibit in this disease, and 
wherein glands in other parts, particularly the neck, are found 
enlarged. In the third stage, the mesenteric glands become irri- 
tated and suppurate ; inflammatory affections of the mucous mem- 
brane hning the bowels are excited; hectic^fever sets in, and colli- 
quative sweats or diarrhea, sooner or later, carry off the patient. 

The first stage begins insidiously; the digestion is disturbed; 
signs of irritation of the bowels are observed, recovery from which 
is slow; they recur on slight excitement; the belly remains per- 
haps full and hard, and the flesh wastes away, notwithstanding 
an appetite probably voracious or fanciful. We should now take 
alarm, and suspect that disease is set up in the mesenteric glands. 

If we can feel the enlarged glands, we are made certain. 

The second stage is better marked. The patient should be ex- 
amined while fasting, and we may detect the enlarged and hard- 
ened glands about the middle of the abdomen; and pressure on 
them often gives some pain. If the masses felt proceeded from 
hardened feculent matter, no pain is caused by pressure ; and, 
moreover, these feculent masses are felt more to the side, in the 
course of the large bowels; nor does the taking of food, or an 
evacuation, excite pain, or the latter relieve the uneasiness, as 
either does when a feculent collection alone is present. The un- 



496 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

easiness or pain in mesenteric disease is increased by running, leap» 
ing, hiccup ; also by the upright position or bending of the back ; 
the pain occurs, too, about the same hour of the day, lasts long; 
or, if absent for a few days, recurs with severity. The appetite 
is variable, sometimes voracious, and acid or indigestible food is 
fancied ; emaciation proceeds, although much food be consumed ; 
the belly becomes swollen and hard. We can distinguish that 
these symptoms do not proceed from any irritation in the stomach, 
by finding that stimulating articles of food do not aggravate them. 

And now white, chalky-looking stools are observed, which have 
been assigned as the characteristic signs of the second stage. 
These white stools are the exponents of irritation in the mucous 
membrane of the bowels, and do not depend on the presence of 
chyle, which has been prevented passing through the lacteal ves- 
sels, nor on calcareous matter passing from the bowels, though 
they look almost like pieces of mortar. 

W®rms are not unfrequently present, and, when voided, they 
are looked upon as causes of the disorder, but they are only acci- 
dental complications. 

In this disease, the accompanying fever may present itself under 
one of two aspects — under that of remittent fever, and that of 
hectic. If the irritation in the mucous membrane predominates 
largely over the tubercular deposit and the tubercular tendency, 
the fever will be of the remittent character or type, and abdominal 
inflammation may terminate life ; if the reverse, then hectic fever 
is the accompaniment, and the sufferer dies from exhaustion. 

In the third and last stage, the diseased glands have formed 
matter, which matter can often be detected in the discharges from 
the bowels on accurate examination. The peritonaeum (membrane 
lining the bowels) becomes inflamed, and fluid is poured out within 
the belly, or inflammation and ulceration of the bowels themselves 
take place. Constant diarrhea attends, and helps to rapidl}^ ex- 
haust the patient, together with the cough which so often declares 
that consumption is raging at the same time in the chest. 

Should any enlargement of the cervical or other superficial glands 
prevail, we may, by observing their state, give a good guess as 
to the state of the glands within the abdomen ; if those under the 
skin in the neck or groins are softening, it is likely the mesenteric 
are undergoing, or are about to undergo, a similar change. 

Treatment. — In this alarming disease, we must try hard to arrest 



^ 



ATROPHY— MESENTERIC DECLINE. 497 

the mischief while in its first stage ; if it reaches the second, our 
probability of witnessing a recovery grows less and less, until, in 
the third stage, no hope at all ought to be given or entertained. 

The treatment of the eajrly stage is that adapted to remove irri- 
tation and inflammation. Local depletion ; a very carefully-regu- 
lated diet, fomentations and warm baths, stimulating embrocations 
or liniments. If the bowels are confined, which they may be at 
first, then a little rhubarb with sulphate of potash should be given; 
but in the more frequent case of diarrhea, we may give gray pow- 
der (mercury with chalk), one grain, with one, two, three, or four 
grains of compound chalk powder with opium, two or three times 
a day ; and the diet should consist of farinaceous food chiefly, so 
long as the local irritation seems to continue ; but as the signs of 
local irritation and of fever give way, the diet must be more nu- 
tritious, and animal food allowed. 

If the looseness is excessive, the chalk mixture of the Pharma- 
copoeia should be given, with or without infusion of catechu, equal 
parts ; but since the diarrhea depends rather on irritation of the 
mucous membrane than on any other cause, we shall stop the one 
by removing or alleviating the other. 

Stimulating embrocations and liniments are of great service 
usually. Spirits of turpentine, made warm, by putting some into 
a cup placed in boiling water, is a powerful reddener of the skin ; 
so are linen compresses wet with the turpentine. They are to be 
left on the abdomen until a sense of tingling arises. 

Another remedy is the croton-oil embrocation — thirty drops of 
the oil to an ounce of soap liniment — two tea-spoonfuls rubbed 
gently night and morning, until redness and angry-looking pim- 
ples burst forth. Or this : 

No. 219. Liquor of ammonia 2 drachms. 

Opodeldoc 1 oz. 

Mix. 

Or the tartar emetic ointment, consisting of tartar emetic sixty 
grains to one ounce of lard, or a liniment of soap liniment and 
tartar emetic in similar proportions. 

For internal medicines, either of the following, to a child eight 
to twelve years old. If there is no diarrhea, this may be given. 

No. 220. Infusion of calumba 6 oz. 

Bicarbonate of potash 60 grs. or 1 dr. 

Medicinal hydrocyanic acid 6 drops. 

Mix. One-sixth part three times daily. 
32 



498 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

If there is diarrhea — 

No. 221. Compound chalk powder 2J- drachms. 

Tincture of opium 20 drops. 

Infusion of calumba 8 oz. 

Mix. 

Two table-spoonfuls, two or three times a day. 

But of all remedies, during the first stage, and, indeed, during 
the three, the cod-liver oil is most to be preferred ; the only ob- 
jection is, that the stomach is often too irritable to bear it, and it 
is sometimes rejected by vomiting, or else there is a taste of the 
oil left in the mouth for hours afterward, which children can not 
easily bear. We may sometimes obviate this by giving, just after 
the oil, or before it, about the third or fourth of a drop of the 
medicinal hydrocyanic acid, in some distilled water. 

The dose of the oil should be a tea-spoonful to a child of from 
eight to twelve years of age ; and it must be cautiously increased. 

If, however, the oil can not be borne in this way, we should rub 
it into the abdomen, two drachms to half an ounce, mixed with soap 
liniment, night and morning, taking care to prevent the smell from 
affecting the child, as much as possible. This oil serves both as 
nutriment and as a check upon the emaciation, while it possesses 
a tonic property, and exercises some influence as an absorbent on 
the hardened glands. 

The treatment, then, is comprised in warm baths and very un- 
irritating diet, while fever, local pain, swelling, and tenderness 
exist. When this state has been subdued, then tonics and a more 
animalized diet, while, in all the forms, counter-irritation must be 
steadily maintained. 



Disease of the Brain, and Convulsions in Children. 

Inflammation of the brain in children of a scrofulous habit often 
depends on a deposit of scrofulous or tubercular matter in certain 
parts of it, and, together with convulsions, cuts short the lives of 
many infants and children. It may also depend on simple inflam- 
mation of the brain ; that is to say, of inflammation unconnected 
with scrofulous action. 

In the first stage the symptoms are premonitory ; there is gen- 
eral febrile disturbance ; the child's manners are altered, its spirits 
variable ; there is an appearance of heaviness, giddiness, dizziness. 



DISEASE OF THE BRAIN AND CONVULSIONS. 499 

headache ; appetite bad or variable ; thirst considerable. The child 
seems to halt in its gait. 

The child vomits — sometimes after food only ; at others, when 
the stomach is empty, when some greenish phlegm is brought up. 
The attacks of vomiting occur two or three times a day. The 
child's head seems to grow heavier; headache, and often severe. 
The bowels are generally constipated from the first, and the scanty 
discharges are pale or mud-colored, very offensive, and seem to be 
deficient in bile. The abdomen is seldom full, though there may 
be pain or tenderness. The tongue, usually, is not dry; rather 
red at its tip and edges, with a white fur on the center, a yellow- 
ish coating at the root. 

The skin is harsh and dry ; the nostrils are dry ; pulse quick, 
but seldom exceeding 120 in children of four years old and up- 
ward; nor is it full, but often unequal. Drowsiness, yet restless; 
grinds its teeth during sleep ; lies with its eyes partially open ; 
often wakes or starts up in alarm without any cause. 

Light is badly borne. 

Now, this precursory stage may last for four or five days, after 
which the second stage may be considered to have commenced. 
Here we may recognize the disorder, though much of the hope of 
recovery must be given up. The face shows anxiety and suffer- 
ing ; the child wishes to lie quiet, and not be disturbed ; there are 
no intervals of cheerfulness; the eyes are kept closed, eyebrows 
knit, as if the child strove to shut out the light from the too sen- 
sitive eye ; skin continues dry, face flushed, head hot. The replies 
to questions are very short, generally rational ; much irritability ; 
drowsiness increases. Sometimes a short, sharp, lamentable cry 
is heard, alternating with a low moan. In other cases, children 
scream out, "My head! my head!" 

As night approaches, the symptoms increase in intensity, and the 
quiet state of the day is changed at night for an excited state, and 
violent complaints are made about the head's suffering. Delirium 
may now appear. The pulse quickens ; may become irregular or 
diminished in power. 

The eyes are sometimes kept so firmly closed that we can hardly 
get a peep at the pupils. Usually they are not much affected ; but 
sometimes one is more dilated, and acts more sluggishly than the 
other. At times squinting exists, at least in one eye. 

Vomiting seldom continues beyond the commencement of this 



500 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

stage ; but there is no more desire for food or drink than before 
the cessation of vomiting. 

The bowels become more and more confined, and so shrunken 
that such a shrunken form was considered characteristic of hydro- 
cephalus. The evacuations continue unnatural throughout. 

The third stage commences by a deepening of the state of drowsi- 
ness, and this drowsiness becomes a stupor, from which it is impos- 
sible to awake or arouse the child. 

An attack of convulsions sometimes precedes this stupor ; and 
they aifect, in most cases, one side more than the other, leaving 
behind them one side more or less palsied, or the limbs stiff and 
contracted. The child is continually moving the other side, (the 
one not palsied,) carrying the hand to the head, and bending and 
stretching out the leg. 

The child now lies in a state of complete insensibility,- one leg 
stretched out, the other drawn up to the body, and picking its lips. 
The head is flushed, and usually remains permanently hot ; the skin 
is dry, though perspirations may break out ; the pulse becomes a 
mere thread, and too rapid to count ; squinting is observed, but the 
light no longer offends the now insensible eyes ; the eyelids are 
open, and the eyes turned upward ; they roll ; the pupils are fixed 
and glassy, the whites of the eyes bloodshot ; and the back part 
of the head is kept boring into the pillow, and, ere long, a fit of 
convulsions terminates the suffering. 

The symptoms run this course in many cases, but they may 
vary. All attacks are usually preceded by signs of impaired gen- 
eral health — sometimes by cough and a threatening of the chest, 
until vomiting, convulsions, stupor, and coma point out where the 
mischief is going on. 

I will divide this disease into four stages. 

1st. That of turgescence. — Dry skin, hands to head, pulse weak, 
gait tottering. This stage lasts often fourteen days. 

2d. Inflammatory period. — The signs of inflammation of the 
brain ; lasts two to six days. 

3d. Period of effusion. — Insensibility in every shape ; picking 
of nose, kicking of bedclothes ; emaciation advances, and complete 
coma is established ; lasts from ten to thirty days. 

4th. Stage of palsy. — Convulsions ; then palsy, generally of the 
right side, with cramp ; drawing the head backward, pupils dilated, 
stools passed involuntarily, etc. 



DISEASE OF THE BRAIX AND COXVULSIONS. 



601 



Worm fever may be confounded with this disease ; the differ- 
ences are as follows: 



Disease of the Brain 

seldom lasts less than thirteen or 
more than thirty days ; has stages ; 
if not cured in first or second day, 
always fatal. 

No distinct remissions ; is never 
epidemic. 

In second stage, has violent pain 
in the head. 

Appetite in first stage is lost ; 
costiveness; urine scanty — at first 
milk-white, then yellow, with sedi- 
ment. 

The pulse in the first stage is 
almost natural ; in the second and 
third, preternaturally slow ; in the 
last only, quick. 

Skin is dry, until effusion oc- 
curs. 

Walk unsteady and uplifted. 

The sight over-sensitive in the 
first stage, dim in the second, and 
blind in the third. 

Yomiting invariable in the sec- 
ond stage. 

The head is hotter than other 
parts. 

Emaciation ; belly falls in ; no 
flatus. 

Palsy, cramp of spine, general 
convulsions. 

Near the end, a hectic flush, with 
alternating paleness ; and tips of 
fingers red; a peculiar eruption 
about the mouth and other parts. 

Countenance expresses suffering. 



The Worm Feyer 
has no stages ; seldom terminates 
before the twenty-first day — often 
not till the fortieth — and may be 
cured at any period of the disease. 

Has commonly remissions, and is 
sometimes, though not commonly, 
epidemic. 

The pain is dull, and exists at 
same time in the belly, but dull 
and not distinct there. 

A greedy appetite ; large stools 
are often passed, and much color- 
less urine. 

In worm fever, pulse is always 
quick. 



Perspiration after eating or 
drinking, with fever signs. 

Walk only slow. 

Not so in worm fever ; there is no 
blindness; the nostrils are moist. 

Yomiting is accidental ; when 
worms get into stomach, peculiar 
foul smell of the vomited matter. 

The belly is hotter than other 
parts. 

No wasting ; belly does not 
shrink, and there is wind in the 
bowels. 

Convulsions without palsy. 

Not so in worm fever ; and if 
there is any eruption, it is only a 
miliary one, which is an usual ac- 
companiment of gastric disorders. 

Not so in worm fever. 



502 AMEKICAN HOUSEHOLD BOOK OF MEDICINE 

Convulsions proceed from some aifection of the spinal marrow, 
and they may be excited by causes susceptible of removal ; still, 
they accompany, as we have seen, the foregoing very fatal disease. 
We should take alarm when we see the thumbs drawn into the 
palms of the hands, either habitually or during sleep ; when there 
IS not only twitching of the angles of the mouth, but of the face and 
limbs ; when there is sudden starting from sleep, the face flushed 
or livid, the eyes turning up under the upper eyeUds, the pupils 
dilating, the countenance betrays anxiety or terror, and when the 
child utters a cry, or shrieks occasionally. 

These signs indicate that nerves are involved which belong to 
the brain, and not to the spinal marrow. 

To add to the difficulties of this distressing disease, we not un- 
frequently meet with deceitful lulls or remission of violence in the 
symptoms, which give great hope to the anxious parent, who begins 
to fancy recovery almost secured; and even the medical man has 
been sometimes induced to give and entertain a hope which the 
result disappoints, causing only the greater distress to anxious re- 
lations. 

We must be on our guard against mistaking for this another 
disease of the head, which resembles in many of its symptoms this 
inflammatory one just described; and it is the more necessary to 
avoid any mistake, because the treatment of the two is very diifer- 
ent, and what would be beneficial in the one would cause death in 
the other. 

In inflammation of the brain there is an inflamed state of the 
brain, accompanied by increased action of the blood-vessels. In 
this disease there is a want of blood, or a diminished supply of the 
red blood ; and thus we find that exhaustion of the nervous power 
may produce symptoms very much resembling those proceeding 
from a reverse condition ; and defect of pressure on the brain 
causes symptoms much resembling those proceeding from exces- 
sive pressure. 

If a human being were to bleed to death, as in uterine hemor- 
rhage, we see these persons become delirious, convulsed, and then 
insensible, with a wide and fixed pupil, and these are the signs of 
a reverse state, how are we to distinguish ? 

This disease has been called spurious hydrocephalus, or water 
in the head. 

There is heaviness of the head, and drowsiness ; the patients 



DISEASE OF THE BRAIN, AND CONVULSIONS 503 

were from a few montlis to two or three years old ; tliey were of 
small size, or else had been badly nursed, badly fed, or been weak- 
ened by some exhausting disease. The physician finds the child 
lying on its nurse's lap, unable or unwilling to raise its head, half 
asleep, one moment opening its eyes, the next closing them again, 
with a remarkable expression of languor. The tongue is slightly 
white ; the skin not hot; at times the nurse remarks that it is colder 
than natural; in some instances there is an occasional transient 
flush. In most instances there had been leeches applied, purgatives 
given, and all the usual measures of treating inflammation of the 
brain had been in requisition, not only without benefit, but with 
aggravation of all the symptoms. 

The distinctive characters of this spurious form of water in the 
head are, a pale, cool cheek ; a half-shut, regardless eye ; an in- 
sensible pupil, an interrupted, sighing respiration ; and our judg- 
ment may be aided by the history of the case, by learning what has 
preceded in the shape of exhaustion, producing causes, bad food, 
weaning, diarrhea, etc. What adds much to the difficulty in dis- 
criminating, is derived from the feeble attempts at reaction which 
are set up ; then great care is required. 

We should pay particular attention to one circumstance, which 
some declare to be characteristic, and that is, as to the state of 
the fontanelles. 

The fontanelles are certain portions of the newly-born child's 
head which at birth are not covered with bone, but with cartilagi- 
nous membranes. Every nurse knows these softer spots. It is 
by examining the fontanelles in young children that we can dis- 
criminate between a state of exhaustion and one of congestion, 
between too much and too little pressure, between fullness and 
comparative emptiness. 

If we find the surface of the unclosed fontanelle convex and 
prominent, the symptoms proceed from fullness and inflammation; 
if the surface is concave and depressed, then there are emptiness 
of the vessels, and want of support to the brain. In the former 
case, leeching and depletion must be used, and they will do good; 
in the latter, we must give ammonia or brandy, and support the 
powers, avoiding evacuants and depletion of all kinds. 

Since the time when the existence and proper treatment of this 
spurious hydrocephalus was established, similar principles have 
been applied to other diseases, and many a patient, who might have 



604 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

been leeched and purged and low-dieted out of life, has been saved; 
and it is now well known to the practical man that in many caseSy 
signs of excitement, it may be of great excitement, may existy 
which will admit of and require a treatment which might appear to 
be totally inert, because they are coexistent with a want of power 
in the constitution, and of strength to withstand the assault of the 
disease, and the effects of an exhausting or depleting system of 
treatment. 

The treatment of this spurious hydrocephalus is, in giving to a 
child, about a year old, eight or ten minims of the aromatic spirit 
of ammonia, in a little water, every four hours, and in ordering 
asses' milk, from a pint 'to. a quart, in the twenty-four hours. All 
exhausting discharges must be restrained, and all causes of de- 
bility removed. If there is diarrhea, give a little compound chalk 
powder (see Diarrhea). The child must be kept in a recumbent 
position; admit free air, but keep the child's body and limbs w^arm 
with flannel. 

Instead of the ammonia, from five to ten drops of brandy may 
be given, in arrowroot, every four hours. 

Treatment of Disease of the Brain.— l^his is an inflammation, 
and the only means of safety lie in its complete removal ; but we 
must bear in mind that it is an inflammation in scrofulous children, 
and that there coexists a want of power and strength, such as has 
just been alluded to. 

Blood used to be taken away by the lancet, even to fainting, 
once or twice ; but some of the most judicious practitioners now 
rely upon leeches, and think they produce an effect tantamount to 
venesection. They should be applied rather to the crown of the 
head than to the temples, where they dangle about the eyes to the 
terror of the child ; or than behind the ears, where they are liable 
to be rubbed off, as the child's head rolls about from side to side. 
The number of leeches to be applied must depend on the age of 
the child, on the violence of the symptoms, and on the greater 
or less apparent strength of its constitution. Assuming that one 
leech will, on an average, cause the discharge of one ounce of 
blood, we may apply three of them to a child six months old ; that 
is, if the symptoms are violent. If fainting occur, the flow of 
blood must be stopped. A full bleeding for a child five or six 
years old is six ounces ; but the measure and test of salutary 
blood-letting may be seen in the effect produced at the time* The 



DISEASE OF THE BRAIN, AND CONVULSIONS 505 

first bleeding, whether by leeches or lancet, should produce a 
manifest and decided impression. The force of the early disease 
is more surely and safely thus broken than when- by bleeding in 
driblets. 

If the pulse continue equally high, the pain equally distressing, 
the fever as great, as they were before the application of the 
leeches, and the child's strength does not seem materially reduced, 
again apply leeches ; but as soon as general convulsions, or the 
state of coma occur, taking away more blood is useless and per- 
nicious. 

Purgatives should form our sheet-anchor, whether preceded and 
accompanied or not by drawing of blood. They correct depraved 
secretions, they clear the bowels of all irritating contents, and they 
seem to derive from, that is, lessen, the load on the brain. The 
purgative should consist of calomel and jalap, or of calomel and 
scammony; and senna and salts must be given to secure their 
operation. 

Purgatives are very effective agents in combating inflammation 
of the brain, whether in the child or the grown-up person, and no 
other means produce so decided a relief as purgatives. 

The calomel and jalap or scammony, unfortunately, are rejected 
sometimes from the stomach ; then a large clyster may help ma- 
terially, both in settling the stomach and in procuring stools. A 
drachm or two of magnesia, saturated with lemon-juice, every two 
or three hours, has quieted the irritable stomach and produced dis- 
charges. The purgatives are to be continued for several days. 
This disease of the brain seems to cause a torpor of the bowels, 
so that it is often very di&cult to procure evacuations from them. 
The late Dr. Gregory gave one child 140 grains of calomel in five 
days ; yet the bowels were not relieved till the patient had taken 
thirty grains, and a second dose of 35 grains of jalap. In another 
child, twenty-eight months old, 350 grains of calomel were given 
in nine days (nearly 40 grains a day) ; and in six of these days, 136 
grains of jalap (more than 20 grains a day). The effects were a 
gentle purgation from the jalap, none from the previous calomel, 
and but slight salivation. The child recovered after having been 
nearly in a comatose state. 

Of course we must try small doses first. 

Cold applied to the head is especially useful when there is much 
heat of head, and after the bowels have been freely opened. A 



506 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

linen rag, wet with cold water, or spirit and water, must be put 
and renewed as often as it becomes hot, or water may be allowed 
to drop continu-allj upon the heated head ; and the dripping stream 
should be continued until the head no longer recovers its high tem- 
perature upon intermitting the dropping. 

Mercury is much relied on by many in this disease, and some 
would salivate, if they could ; for they have observed some cases 
to do well when salivation has commenced. It is, however, very 
difficult to salivate children, fortunately ; for, when salivated, they 
suffer much indeed. Calomel should be given in moderate doses, 
about 1 grain, or even 2 grains, every four hours, to a child about 
twelve months old. If these doses purge, do not add opium, but 
some kino or catechu ; and if it still operate freely on the bowels, 
discontinue the powders, and let 30 or 40 grains of mercurial oint- 
ment be rubbed into the inside of the thighs every night. In all 
cases, discontinue the calomel as soon as green evacuations pass 
from the bowels, resembling wet tea-leaves or chopped spinach. 

Blisters, during the early inflammatory stage, should not be ap- 
plied ; they may only add to the irritation ; but during the period 
when coma makes it appearance, blisters are likely to prove serv- 
iceable. 

Dr. Golis's plan of treatment, whose great experience in this 
disease gives weight to his recommendations, is this : In the first 
stage, a dark room, repose ; to be kept cool rather than warm. 
In children from one to five months, one-fourth of a grain of calo- 
mel ; in those from six months to two years, half a grain every 
two hours, till four or six green stools appear. In irritable, cos- 
tive habits, a few grains of roasted jalap may be added. If col- 
icky pains or looseness ensue, leave off, and resume the calomel 
at longer intervals ; but violent pains in the belly, diarrhea, and 
gastric irritation forbid calomel. 

Emollients may be given. Infusions or decoctions of marshm al- 
lows or barley, or gum arable water, with or without niter. Gum 
arable emulsion relieves the headache sooner than any thing. No 
other medicines externally; cold to head, mustard foot baths, blis- 
ters, and m.ercurial frictions ; this is the only stage for mercurial 
frictions. Mercurial ointment, 60 grains to nape of neck, back of 
head, and thighs, every three hours. 

Inflammatory stage, blood-letting, in children from six to twelve 
months ; if the attack be sharp, three, four, or five ounces of blood 



CHRONIC HYDROCEPHALUS, OR WATER IN THE HEAD. 507 

may be taken ; but I rely upon leeching ; and in children of the 
second, third, or fourth year, six ounces of blood have been drawn. 
A second bleeding should never be required. Continue the calo- 
mel until colicky pains and green stools follow. Cold to head, ap- 
plications to feet as before, blisters to the belly ; for, if applied to 
the head, they interfere with the cold applications. Too late for 
mercury. 

And if we have succeeded in checking or curing the disease, 
then tonics, with caution, and blisters kept up for some time. In 
the last two stages the treatment is merely palliative. Such are 
the directions of Dr. Golis, as the most conformable with his ex- 
perience. 

In this, as in every other fatal disease, prevention ought to be 
the great object aimed at, by avoiding all exciting causes of dis- 
ease, whether mental or corporeal; disease once estabhshed in a 
scrofulous habit is very difficult to combat. 

Chronic Hydrocephalus, or Water in the Head. 

The acute form is an inflammation ; this may be termed a dropsy. 
There are certain parts of the brain, called ventricles, or little cav- 
ities, w^ithin which a watery fluid collects ; and why it collects we 
know not, only we observe that such circumstances happen only 
or chiefly to those w^ho are of a strumous habit. This collection 
happens at an early period of life, and before the whole of the 
brain-case has become solid ; the bones, or rather the containing 
parts, yield to the pressure, and the head is increased in size, and 
the functions of the brain are more or less deranged. Sometimes 
these collections of fluid have taken place before birth, and the 
pressure during child-birth has caused the head to burst, and death 
immediately to ensue ; but, in most cases, the fluid begins to accu- 
mulate at some uncertain period after birth, and the collection in- 
creases often rather rapidly ; and the bones are separated from each 
other as the pressure from within the skull continues to increase ; 
the forehead is tilted forward, so as to overhang the brow ; the 
side bones of the head bulge above ; the back head bone is pushed 
back, and the head may become long, broad, and deep, but flat- 
tened at the top. The inward pressure from the fluid might cause 
the head to assume difi'erent shapes, but in all there is a peculiar 
and odd look; the face is triangular; for while the bones of the 



508 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

skull are, it may be, rapidly enlarging, the bones of the face do 
not grow faster than usual, perhaps not so fast. This dispropor- 
tion between the size of the head and face, is said to be very char- 
acteristic of water in the head. 

The child is topheavy, and the muscles of the neck can not sup- 
port the weight of the enlarged head, and the child is found to be 
deaf or blind, or, perhaps, palsied in one or more of its limbs, or 
idiotic, or all these. The issue of the majority of these cases is, 
that they either die or recover during infancy ; a few survive for 
an uncertain number of years, and enjoy sufficient intellect for the 
common purposes of life. In these latter cases, the liquid within 
the brain causes the substance of the brain itself to expand into 
new forms ; there is no loss of the substance of the brain, for the 
pressure of the contained liquid has been gradual, and the unfold- 
ing of the brain has been also gradual. So long as the brain-case 
yields to the pressure, and there is no counter or opposing pres- 
sure, all goes on well enough ; but there is a time when the open- 
ing in the skull, so remarkable at birth (called the fontanelles), close 
up, and this time is a period of danger. It may happen that, 
though the fontanelles are closed, the bones of the head still have 
left intervals of membrane between the points of ossification, which 
yield to the pressure, and it may happen that the distending force 
causes the lines, called the sutures, to break open, and to separate 
more or less widely, effectually relieving from all pressure. 

Treatment. — Mercury seems to be the only remedy that has done 
any good, though purgatives and diuretics have been praised. 
Leeches occasionally may be applied, and they will help. The 
German physician Golis, who has written on this subject, advises 
us to give calomel, half a grain, twice a day, or, if half a grain 
purge, then only one- fourth of a grain ; and, also, at the same time, 
to rub into the scalp from twenty to forty grains of mercurial oint- 
ment, mixed with ointment of juniper berries, every night, and a 
woolen cap is to be kept constantly on the head. PtyaHsm (an 
abundant flow^ of saliva) is but seldom produced in children. 

There are two mechanical remedies ; one acts by relieving the 
pressure, and the other by compressing the skull bones. The first 
can only be done by a surgeon ; it is to let out the fluid by opera- 
tion, and recoveries are on record of the successful results. The 
other might be tried — it is bandaging the head. We have seen 
that safety can only be secured by the yielding of the bones, so 



THE THRUSH— APHTHiE— STOMATITIS. 509 

long as tlie fluid is increasing ; but when the disease is stationary, 
and the unconnected bones are loose, and the child pale and languid, 
moderate pressure may help very much. 

Strips of adhesive plaster, about three-quarters of an inch wide, 
are applied completely around the head, from before backward, 
reaching low down to the tops of the ears, and lapping behind over 
each other. Cross strips are then applied. All will depend on 
the accuracy with which these strips are placed, for the pressure 
must bear equally over all points. 

Dr. Arnott's air-press has been recommended as well adapted for 
this purpose, instead of the strips. 

The Thrush — Aphtha — Stomatitis. 

Symptoms. — Heat and redness of the lining membrane of the 
mouth to a greater or less extent ; the tongue and mouth are often 
dry, the lips often swelled, and are surrounded by an eruption, and 
sometimes there is a dribbling of saliva. 

This is inflammation of the mouth, which is caused by improper 
feeding or by cold, and requires usually only mild drinks, barley- 
water, mucilage of gum, etc., unless it be merely a sign of irrita- 
tion in the bowels : then the bowel disorder requires attention. 
But there is also an inflammation attended with ulcers, and then 
the disorder is called the thrush. In some cases the ulcers are of 
a common character ; they are usually large and irregular in shape, 
covered with white or yellowish sloughs or coats, and are sur- 
rounded by much redness. They may be observed on the inside 
of the cheek, roof of the mouth, or on the tongue even. Some- 
times, about the period of the first dentition, the gums become 
spongy, and of a dark purphsh hue, and the ulcers bleed often. 
Local irritation, with fever, restlessness, and disorder of the diges- 
tive organs attend. 

Treatment — Treatment of this ulceration consists in touching 
the ulcers with a linctus : 

No. 222. Borax or alum 5 to 10 grs. 

Honey of roses 1 oz. 

in regulating the bowels, in light nutritious food, and exposure to 
fresh air. Should the ulcers not look better after a time, then 
touch their surface with lunar caustic, or with this very excellent 
application : 



510 AMERICAN HOUSEHOLD BOOK" OF MEDICINE. 

No. 223. Sulphate of copper 10 grs. 

Honey 1 oz. 

Apply two or three times a day, by means of a camel-hair pencil. 

An anodyne may be required at night to quiet restlessness ; and 
tonics, especially quinine, must be given. 

The ulceration called the thrush, is a small circular white ulcer 
called aphtha, arising at the period of teething mostly, but also 
at other times. 

These aphthae in adults are connected with disease of some in- 
ternal organ, mostly with that of the stomach and bowels ; and they 
sometimes are so connected in children, and are most frequent in 
ill-fed children ; and- they may spread from the stomach to the 
mouth, or may coexist at two distinct points, viz., the mouth and 
the anus. Kissing the lips of an aphthous child may cause the dis- 
order, though the nurse's nipple does not become aphthous, but it 
may be red and irritated. 

They sometimes spread epidemically. 

Symptoms. — The ulcers do not always have inflamed circular 
margins ; the mouth is hot, and the child is fretful and uneasy. 
A small white spot appears, occurring singly or in clusters, on some 
part of the mouth or throat. When they are very numerous they 
quite cover the inside of the cheek, and become covered with a 
continuous crust or coating of a whitish hue. On removing this, 
ulcers are visible beneath, and the coating is quickly again secreted 
over them. These crusts as they become detached are swallowed, 
and cause disorders of the bowels. 

The bowels are deranged, being constipated, and the secretions 
vitiated ; or diarrhea may attend, and acidity is present ; difficult 
swallowing; and sometimes the tone of the voice alters, or the 
breathing is peculiar, or there is a cough. These last symptoms 
demand attention, for they give token that the inflammation has 
extended, or is extending, to the air-pipes. When the whitish 
color changes to a yellowish or dark color, we should try to as- 
certain if this proceed from their being tinged with bile or blood, 
or whether the changed color is an indication of their assuming an 
unhealthy or gangrenous character. And we may fear this is the 
case when dark sloughs replace the light colored ones. 

Gangrenous aphthae become brown, are covered with a hard sort 
of crust, or one soft and of consistence like thick gruel or panada, 
but when detached the part beneath appears very red or granulated. 



THE THRUSH— APHTHA— STOMATITIS. 511 

The parts around are of a violet hue, and a fetid smell occurs, 
and this is what is called the black thrush. 

Aphthae are not dangerous, whether attendant on other diseases 
or not, or numerous or of long standing or not, so long as they 
remain of whitish color, and the strength of the patient is not ma- 
terially affected ; but they are not favorable when they accompany 
intestinal disorder ; still less so when the color changes, as we have 
described, and the strength fails. 

They are most of all to be dreaded when an extension of the 
disease to the air-passages is to be dreaded; so, when the child's 
voice becomes hoarse or indistinct, and the breathing croupy and 
spasmodic, with fits of suffocation and cough, immediate danger 
threatens, if indeed the case be not already hopeless. It is won- 
derful how small an amount of ulceration seems capable of destroy- 
ing life, if once aphthae pass over or even reach the cheek at the 
top of the wind-pipe, or rather voice-pipe. 

Treatment. — When these aphthae are local, local means suffice 
to cure. A dose of castor-oil, with the borax or alum linctus. If 
there is acidity, instead of castor-oil, give 

No. 224. Powdered rhubarb 20 grs. 

Powdered magnesia 40 grs. 

Cinnamon powder 10 grs. 

Mix. 

Three or four grains every third hour, to a child of six months, 
until the effect desired is produced. Six to ten grains if the child 
is a year old. 

When the bowels are too loose, the compound chalk mixture, 
and every night gray powder with Dover's powder ; but when the 
general powers fail, then the quinine mixture and the ammonia, 
with the citrate of iron, must be given. 

No. 225. Distilled water IJ oz. 

Sulphate of quinine 2 grs. 

Sulphuric acid 16 drops. 

Syrup -^ oz. 

Mix. 

Dose — One or two tea-spoonfuls, two or three times a day. 

The local treatment has been alluded to. 

A solution of cloride of soda is useful, but the sulphate of cop- 
per is the most efficient application. 

There are other kinds of inflammation in the mouth, with exuda- 
tion, soft and white ; this may be called the white thrush. 



512 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



Diphtheria. 

This is an acute inflammation of the wind-pipe, characterized by 
a tendency to the formation of false membranes. It is not attended 
with ulceration, but gangrene sometimes follows. 

This form of inflammation varies with the powers of the patient, 
and the degree or character of the attending fever and inflamma- 
tion ; and it may rage as an epidemic, attacking adults as well as 
children. Our chance of successful treatment depends on our early 
distinguishing the nature of the disease, for that is the time to 
arrest its progress. There is an exudation or pouring out of a 
secretion, which forms, a membrane, but there is no breach of sur- 
face, no ulceration. 

We find the mucous membrane of the mouth and gullet of a 
bright red color, which membrane becomes quickly studded with 
specks or patches of false membrane, seen on and at the back 
part. They soon become a continuous layer of a thin, white, con- 
crete substance in severe cases, or in still severer, the lymph is 
deposited in masses of a gray or yellowish color. This may be 
scraped off, but it is soon replaced, the palate and neighboring 
parts swelling, though swallowing is not difiicult, nor is there much 
pain. The accompanying fever is slight, but when this accom- 
panying fever assumes the malignant or typhus type, the epidemic 
is likely to be of a fatal nature. 

This malignant form begins insidiously, but from the beginning 
there are signs of prostration of the bodily and nervous powers, 
which foreshadow the approaching danger. The redness is trifling, 
but swallowing soon becomes difficult, and often liquids are re- 
turned through the nostrils ; the glands under the chin swell. The 
membrane formed is extensive, and is a of yellowish gray or dirty 
ash color, and when tinged with blood it is of a dark color, and smells 
most fetidly. If scraped oif, the parts beneath are not ulcerated, 
and the fetor seems to arise from the putrefaction of the membrane. 

The danger arises from the extension of this membrane into the 
air-passages, and this will certainly occur if the disease be not ar- 
rested in its progress, or if the sufferer be not previously destroyed 
by the accompanying malignant fever. The skin is cool ; the pulse 
rapid and feeble ; delirium and stupor follow, and the patient may 
be cut off in a day or two, or within the first twenty-four hours. 
The extension into the air-passages is made manifest by the ad- 



DIPHTHERIA. 513 

dition of signs of suffocation, by a hoarse or indistinct voice, by a 
frequent, harsh, croupy cough, by laborious and convulsive breath- 
ing. The face becomes pallid, then livid, and coma or convulsion 
follows. 

Strong and healthy persons, and children living in healthy sites, 
do not often suffer from this malignant form, though in an^'epi- 
demic they may not be spared. 

We distinguish diphtheria from the thrush, either white or black, 
and from gangrenous sore throat, by scraping off a portion of false 
membrane ; when in the diphtheria, we find the subjacent surface in 
a. state of integrity, whereas in the other two ulcerations become 
immediately perceptible. 

Treatment. — Our main object is to prevent the spreading of the 
membrane into the air-passages. To have a chance of doing this 
effectually, be careful to examine early the mouth, for the mem- 
brane is sometimes completely formed before any uneasiness is 
felt in the parts. The instant we see the membrane, we must, by 
means of a camel-hair pencil, apply a strong solution of lunar 
caustic (nitrate of silver), twenty grains to one ounce of distilled 
water, all over the diseased parts, and this must be repeated to 
prevent a renewal of the membrane, which is liable to recur. Thus 
we arrest the spread of the inflammation and check the deposition 
of lymph, when done at the very outset. A saturated solution of 
the sulphate of copper (that is, as much sulphate of copper as the 
water will dissolve) will produce a similar effect. 

But if we see the disease in a severe, malignant form, or at a 
later period, our application must be more influential than the 
above-stated, and we must apply freely, by means of a piece of 
sponge attached to the end of a probang or a common stick, a 
mixture of muriatic acid with one or two parts of honey. The 
sponge is to be pressed firmly against the membrane, which thus, 
even after it has become putrid, has been destroyed and detached. 
It is often necessary to apply the acid a second or even a third 
time; usually twice in twenty-four hours will suffice. 

Mercury has been recommended, and in grown-up persons it 
may be useful in checking the membrane, producing inflammation ; 
but it is of little or no use with children, except as an aperient. 

An emetic might be given at the commencement, to dislodge the 
membrane, but our chief reliance is on the local treatment, except 
in the mahgnant or epidemic form ; then general treatment, to keep 
33 



514 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

up the powers, becomes as necessary as the local treatment. Am- 
monia, ether, quinine, and wine in arrowroot or sago, must be 
given, in proportion to the prostration and to the progressive sink- 
ing of the strength. When the fever is of the mild character, 
James's powder, or any of the medicines to induce perspiration, 
may be gis^en. 

Change to another and perhaps a purer air is requisite. 

Canker of the Mouth 

is an ulceration, running rapidly into gangrene ; the symptoms, 
general and local, resemble those already detailed in diphtheria, ex- 
cept that no membrane is formed, nor aphthous specks. The treat- 
ment corresponds, and the applications of sulphate of copper or 
muriatic acid with honey, are to be made in like manner, while 
the fever is to be treated early with tonics and stimulants, as 
typhus fever is combated. 

Mercurial Mouth 

is known by a coppery taste, and a breath with a peculiar fetor in 
it, which may, in most cases, be easily recognized by those who 
have once seen a case of mercurial gangrene in the mouth. Simi- 
lar treatment with the foregoing. 

Some constitutions are so peculiar in respect of the influence 
of mercury, that very slight doses of calomel, etc., produce a most 
extraordinary influence in them, and very slight doses have pro- 
duced most alarming results. I once gave to a lady a pill contain- 
ing one grain of calomel only, yet the mouth, gums, and throat 
swelled to such a degree as to prevent the patient from eating any 
thing solid, and even from swallowing liquids for a fortnight. Had 
I been aware of the idiosyncrasy, I would hardly have dared to 
give one grain of calomel. Time, free air, support, tonics. If gan- 
grene occur, the treatment is that prescribed for diphtheria. 

Infantile Indigestion 

may be divided into indigestion during suckling, and the indiges- 
tion of weaning. 

In the first, the child becomes peevish, fretful ; loses flesh, not- 



INFANTILE INDIGESTION. 515 



withstanding its sucking vigorously; but the more the child sucks, 
the worse it becomes; the milk is soon thrown up again in a curdled 
state, or it is rapidly passed downward ; griping, flatulency, and 
acidity are present, until, at last, diarrhea sets in, which carries off 
the infjmt in from two to four weeks. 

Treatment. — The cause must be discovered, and, if possible, re- 
moved; if the milk is bad, the nurse must be changed; and to check 
the diarrhea, some chalk mixture, with a very cautiously propor- 
tioned addition of opium. The following may be tried : 

No. 226. Chalk mixture 11 oz. 

Bicarbonate of soda 10 grs. 

Syrup 2 drs. 

Tincture of opium 4 drops. 

One tea-spoonful three times a day, increasing the dose grad- 
ually. 

Indigestion during Weaning. — There is always a risk of disease 
at weaning time, and the irritation of dentition takes place about 
this time, too. The food is thrown up, and irritation of the stom- 
ach may be permanently set up. It happens more frequently in 
autumn, and the supervention of the weaning-brash during autumn 
is so remarkable, that Dr. Cheyne advised weaning to be post- 
poned beyond the autumn months, if possible. Bowel complaints 
are always prevalent during the autumnal months. 

Symptoms. — A purging of green matter is generally the first 
symptom, and this disease has, by some, been called the green 
scour. Retching and vomiting are added ; then short periods of 
constipation may alternate, the biliary secretion being suppressed, 
the stools being light and clay-colored, thin and watery, or thick, 
like half-boiled flummery. Peevishness, restlessness ; no desire 
for- food, only for drinks; little fever; pulse scarcely affected; skin 
not very hot ; cold feet and hands ; the belly fall, but not tender ; 
tongue long continues clean and moist, but aphtha may appear at 
last. In some, coma and convulsions come on, and the emaciation 
becomes extreme in about four to six weeks. 

If vomiting be added to purging, the case assumes the appear" 
ance of cholera. 

The food disagrees, an irritation is set up in the bowels, and to 
this inflammation and ulceration succeed. 

As to the result, we may often give hope to a despairing parent, 
even when her child is lying in a state of great emaciation, pro- 



516 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

vided we are sure that we have discovered the cause, and also that 
we can remove it ; it is surprising from what a state of exhaustion 
an ill-fed infant may be recovered. 

Treatment. — Change the nurse, or give asses' milk, with weak 
broth, free from fat ; then arrowroot, or barley-water, with gum or- 
isinglass dissolved in it, may be given. Milk disagrees in general, 
and, if given, it should be previously boiled and diluted with one 
or two parts of water. Boiled bread and milk, or rice milk, have 
"been found to disagree. A good drink may be made by scraping 
some flour which has been boiled in a napkin, and allowed to be- 
come dry, into equal parts of milk and water; then boiling and 
sweetening the mixture. Avoid always much sugar. 

For medicines, those which check the vomiting and purging, 
while they allay the irritation, are the best. Throw up an injec- 
tion of starch mucilage two ounces, and one drop of tincture of 
opium. Then give this mixture : 

No. 227. . Cinnamon water 1 oz. 

Chalk mixture ^ oz. 

Or, instead, 

No. 228. Compound chalk powder 40 grs. 

Tincture of kino 2 drs. 

Syrup 2 drs. 

Tincture of opium. 4 drops. 

One to two tea-spoonfuls every second or third hour, until the 
looseness is checked ; then give it after each liquid stool. 
If the stomach be very irritable, give this : 

No. 229. Mint infusion 1 oz. 

Mucilage of gum ai;abic i oz. 

Liquor of potash 6 drops. 

Syrup 1 oz. 

Compound spirits of lavender 30 drops. 

Tincture of opium 2 drops. 

One to two drachms for a dose. 

Fomentations to the belly of hot flannel, or the warm bath, if 
the child is strong enough. 

If the stools are clayey or light-colored, two or three grains of 
gray powder, with a grain of Dover's powder, or two of the com- 
pound chalk, with opium. 

When debility and exhaustion come on, a drop or two of spirits 
of ammonia, as in foregoing cases. 



CHOLERA INFANTUM. 517 

Cholera Infantum. 

The cholera infantum is a disease confined to children between the 
ages of three months and two years, but which sometimes occurs 
before or after these periods. It is almost always an affectign of 
warm seasons, beginning with the first hot days in April or May, 
not waiting for the month of June, at least in the Middle and 
Southern States ; for we have often observed it in May, though it 
is true that it is mostly an afi'ection of the summer months. When 
autumn arrives, but little more is seen of it until the ensuing year; 
still, however, chronic cases run into this season, and not unfre- 
quently prove fatal in September and October. The cholera infan- 
tum belongs mostly to densely-populated cities and large towns, 
yet it is often met with in the country, indeed much oftener than 
writers on the disease are aware of. We have often seen it in the 
more hilly parts of Ohio, but still more often in the malarious re- 
gions of the West. Wherever infants are badly nourished, and 
kept in close and hot rooms, it is found; and not unfrequently 
among the wealthy, where mothers often suckle badly ; indeed, this 
is one of the causes which is most prominent in the chain of cir- 
cumstances which brings it on. 

Symptoms. — The attack of cholera infantum is frequently pre- 
ceded by diarrhea, though occasionally vomiting and purging begin 
simultaneously. Frequently the vomiting begins before the purg- 
ing, when the disease runs its course in a short time ; the vomiting 
mostly continues to near the last in fatal cases, but when the re- 
sult is favorable, it terminates, after continuing a few hours, in 
diarrhea. This disease is occasionally rapid in its progress, the 
vomiting and purging being almost incessant. Nothing will stay 
in the stomach, and the short intervals are marked by pain and 
languor ; then prostration comes on, with cool and clammy skin, 
and pale and shrunken features ; the eyes are half closed ; the rest- 
lessness is now replaced by insensibility, terminating in coma and 
death, in from twenty-four hours to two, three, or four days. 

More frequently, however, the attack is attended with symptoms 
of fever; that is, there is heat of the skin, with dryness. Under 
these circumstances, the case is frequently protracted through sev- 
eral weeks or more. The fever which attends such cases is char- 
acterized by a feeble and quick pulse, though sometimes corded or 
vibrating. The mouth is hot and dry ; tongue dry and furred ; 



518 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

the temperature of the body and head are above the natural stand- 
ard, while the limbs are below it; delirium, too, occasionally attends, 
with stupor, etc. The abdomen is generally much sunken, but is 
occasionally swollen. As the affection advances, the patient ema- 
ciates rapidly. The flesh now becomes soft and flabby ; the skin is 
either clammy, or harsh and dry ; the tongue still with a white coat, 
or brown, with red edges, and sometimes with ulcerated edges, or 
aphthous. Sometimes the skin has blue patches scattered over it, 
which are often very small. In this way the child gradually sinks, 
but, before death, the eyes become bloodshot, and are kept half 
open, while the sufferer rolls its head, and throws itself from side 
to side, and at length becomes comatose, and not unfrequently dies 
convulsed. 

During the disease there is constant desire for drink, but if taken 
freely, it is immediately thrown off the stomach. Sometimes the 
patient takes food, and frequently desires articles unsuited to the 
disease. A return of the appetite, even in the capricious condition, 
is a favorable symptom. The discharges from the bowels are, 
at the beginning, nearly always light-colored, after the first two 
or three evacuations ; but after the malady has moderated, they 
change, the color becoming dark or light-green, and occasionally 
mixed with mucus or yellowish matter. After some time, the child 
strains when its bowels are moved ; then the evacuations become 
small, and the patient strains much at each evacuation, which some- 
times causes the lower part of the bowel or rectum to protrude at 
every stool, and this condition of the bowel continues for weeks, or 
even longer. The fever attending the disease is always of a re- 
mitting character. As the duration of chronic cases varies very 
much, and although it often wears the sufferer out, it is often sub- 
dued by proper medication, or the coolness of autumnal weather; 
the diarrhea gradually subsides, the appetite becomes less capri- 
cious, the urine is more copious, the liver acts more naturally, the 
skin now loses its unhealthy tone, and becomes soft, with a nat- 
ural temperature, and eventually complete health is restored. 

Causes. — The chief cause of cholera infantum is, undoubtedly, 
owing to bad nursing on the part of the mother, her milk not being 
of the right composition, or deficient in quantity. Often the mother 
is too feeble to give proper nourishment to her offspring; and again, 
she feeds the child on all kinds of food that it wants, and at im- 
proper times, indulging it whenever it cries or shows impatience- 



CHOLERA INFANTUM. , 519 

This course must, in many cases, cause the death of children, foi 
much of their food given in this manner passes through the boweh 
undigested, and, therefore, causes much irritation. 

It is obvious that great heat of the weather, combined with a 
dense population, as in large cities, must often be the direct cause 
of the disease, which is still increased among the poor by the fires 
which they must have for cooking purposes. Hence the necessity 
for removing patients to the country, or open situations, where 
there is free ventilation, which, indeed, is of great importance. In 
the United States the opportunities for change of air and climate 
are probably the best in the world. Our steamboats and railroads 
carry passengers rapidly from one point to another. A sick child, 
in a very low state at Cincinnati, can be taken to St. Paul, the 
Island of Mackinaw, or to Canada, in a few hours. The change on 
patients laboring under chronic diarrhea is seen, often, in a day or 
two. The high situations in various parts of ourcountry, even far 
to the south, will answer an excellent purpose for recuperation. 

Removals to such localities, with proper nourishment, will gen- 
erally give relief. Yet there is nothing equal, with children at the 
breast, to a wet nurse with plenty of milk, which we have observed 
to do more than all other means ; and, when this is done, we 
mostly rely on it altogether, and find it sufficient for the cure ; but 
in older children, change of air is of the greatest importance. 

It must, however, not be forgotten that the time of weaning 
children is at the end of the first year, or about that time. Now, 
teething has only partially taken place, and does not end until 
the close of the second year, which is the one most dreaded by 
mothers, as then feeding has to supply the place of human milk. 
This change frequently brings on various disturbances of the stom- 
ach, that occasionally lead to cholera infantum and its consequences. 
The teething is now more difficult, and for this reason creates more 
disturbance of the constitution, sometimes resulting in head afi'ec- 
tions, diarrhea, and convulsions. It is, however, our opinion, that 
there is generally too many evil consequences attributed to this 
matter, as we have observed that healthy children get through 
their teething without complaint, while the unhealthy seem to suf- 
fer. The fact is, that bad health is the cause of sulFering in teeth- 
ing, and not teething the cause of bad health ; still, it is best to 
watch the condition of the gums, and have them scarified, or cut, 
when much swollen or inflamed. 



520 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

When the chihl is weaned, it then has to rely on other food 
than the mother's milk, which reliance often brings disturbed bow- 
els, unless a judicious course of diet be adopted ; and if the child 
has to be weaned at an earlier period than a year old, still more 
care has to be taken, to prevent diarrhea, etc. In case that the 
child has to be deprived of either the mother's or a wet nurse's 
milk, then the next best course is to feed it on fresh cow's milk, 
diluted about one-third with water. " The farinaceous liquids 
prepared from barley, rice, tapioca, sago, arrowroot, wheat bread, 
water crackers, etc., may also be used ; but care must be taken 
that these substances are entirely free from acidity or mustiness;" 
they should only be given in small quantities at once. From the 
thirst that attends diarrhea, the patients often want to take more 
than the stomach will retain, and when thrown off, the same desire 
still continues ; to relieve this, small quantities of iced-water should 
be given, or, if not easily obtained, water as cold as can be got. 

When the disease is much advanced, and the patient quite en- 
feebled, it is proper to give a portion of animal food, such as weak 
chicken, or mutton broth; and, Dr. Wood tells us, that the child 
may be allowed to suck a piece of ham, or dried salt beef, or fish, 
if these, upon trial, should be found grateful. Where the sufferer 
evinces a longing for some particular article of food, this should 
be responded to as much as possible, and if found to disagree, it 
should be discontinued. The clothing should be light and warm, 
such as light flannel, and ought to be made to cover the upper 
part of the chest and the limbs. 

Treatment hy Medicine. — In the first stage, the attention should 
be directed to checking the excessive vomiting ; for this purpose, 
rubificients ought to be applied over the stomach, so as to excite 
redness of the skin. Mustard and flour, in equal portions, will 
effect this the soonest, and should be first resorted to ; half an 
hour, or an hour, will be long enough to use this application, when 
hot whisky, with mint, may be substituted, or, what is better, black 
pepper, cinnamon, ginger, and cloves, in equal proportions, with 
enough of flour to make a paste, and spread on muslin, so that it 
will cover the stomach and bowels. This plaster should be re- 
newed every four or six hours. Next to these applications are 
those to be taken internally, and we shall advise what we have 
found most useful, and which are most simple. If no other medi- 
cine be on hand, five or ten drops of paregoric should be given in 



CHOLERA INFANTUM. 521 

a little cold water, and repeated every half hour, for two or three 
times. Laudanum, in one or two-drop doses, may be used in the 
same way. Peppermint water, in half tea-spoonful doses, with two 
grains of carbonate of soda and a drop of laudanum, may be di- 
rected every hour or two, with advantage, and during the violence 
of the vomiting and purging, twenty drops of brandy or whisky 
should be given every half hour, until the symptoms abate. But 
what is most useful in thi.« affection, is small doses of calomel, with 
opium in minute quantities. Take ten grains of calomel, with half 
a grain of opium, and a drachm of white sugar, mix them well, 
and make twenty powders. One of these, with a little syrup or 
molasses, should be given to a child two years old every fifteen 
minutes, until the vomiting and purging cease, or until the child 
falls asleep. To a child three months old, only half the amount 
should be given, and a little more, as the age increases. It must 
not be forgotten that a most distinguished physician (Dr. Dewees) 
recommends for the same purpose a tea-spoonful of strong coffee, 
without milk or sugar, every fifteen minutes. Should these means 
fail, from two to six drops of laudanum, with two table-spoonfuls 
of thin starch, should be injected into the bowels, and prevented 
from running off for a few minutes. This may be repeated every 
few hours, care being taken to avoid the improper effect of opium. 
After the vomiting and purging has been arrested for the time 
being, but a diarrhea sets in, the best course then to take is to 
give small doses of calomel, with chalk and Dover's powder, every 
four, six, or eight hours, or less often, according to circumstances. 
To very young children, a fourth of a grain of calomel, with the 
same amount of the Dover's powders, and two and a half grains of 
prepared chalk, may be given, as occasion may require. A good 
method is to give a powder after each evacuation. To patients 
two years old, the dose must be doubled. But when the diarrhea, 
following cholera infantum or not, resists other means, then vom- 
iting with ipecacuanha is the best remedy. This is particularly 
proper when the discharges are frequent and small. For a child 
two years old, five grains should be given at once, and then give 
no more. This amount will mostly vomit the patient ; but some- 
times it does not, but causes sleep, and, at tl>e end of some hours, 
acts on the bowels. Of all the remedies which the writer has ever 
tried, he considers this the best in such cases as" are here described. 
The ipecacuanha may be repeated once a week for a few times. 



522 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

In advanced cases, the following prescription, from Professor "Wood, 
may be tried with advantage : 

No. 230. Blue pill 6 grs. 

Pulverized opium ) ^ ^^^^ 2 

ipecacuanha ) ^ 

Prepared chalk 1 ^ ^^^^ g^ 

(jrum arable j * 

White sugar 1 drachm. 

Mint-water 2 oz. 

Mix these, and give a tea-spoonful every two hours, or as oc- 
casion may require. When there is much debility, eight grains 
of tannin may be added to the mixture with advantage. When 
diarrhea is mild, there is but little needed further than the follow- 
ing prescription : 

No. 231. Bicarbonate of soda i dr. 

Mint-water 4 oz. 

Laudanum 15 drops. 

With a drachm of sugar, combined. From half a tea-spoonful to a 
whole one may be given every four hours, or when food turns sour 
in the stomach. 

There are one or two circumstances which must be observed 
during the course of the various stages of this disease. The first 
is the local congestions or inflammations that sometimes occur 
either in the brain or its membranes, and also in the contents of the 
abdomen. This is known by rolling of the head on the pillow, 
accompanied by wakefulness, and then stupor; the second, by ten- 
derness over the stomach, or at other points of the abdomen. To 
relieve these symptoms, a few leeches near the point afi*ected will 
do most; from two to four leeches are all that should be applied 
at once, but this should be done, if possible, under the direction of 
a physician. When the patient is too sick, or weak from the loss 
of blood, small cups should be used, with or without scarifications ; 
and after or before liniments should be used, or fomentations with 
hop-water, or warm water alone. The second circumstance is the 
debility which attends the advanced stages of the disease. It often 
becomes necessary to give gentle stimulants in these cases, which 
not unfrequently save the lives of patients worn down to the last 
degree of debility and emaciation. Wine is the best of stimulants in 
such cases, and of all the wines that can be got in this country, the 
native wines are the best, and those called sparkling are preferable. 
A tea-spoonful of the sparkling or still catawba may be directed 



DIARRHEA. 523 

three or four times a day. During the earlier stages of the disease, 
as has been stated, good spirits are sometimes preferable. 

In malarious localities, infants are occasionally born with a pre- 
disposition to ague, and we have seen a few cases where it came 
on but a few days after birth ; but it much more frequently maizes 
its appearance within a few weeks, and often does not appear until 
the end of the first year, or later. Now, these infants, thus dis- 
eased, are subject to the cholera infantum more often than those 
not laboring under it. The treatment, then, must be different. To 
what has been directed for the cholera infantum, must be added 
quinine, in suitable doses, which should be given in solution, and, 
to a child two years old, in half grain doses, every four or six hours 
during the interval. To younger children, the dose may be dimin- 
ished to the fourth of a grain. Four grains of the sulphate, dis- 
solved in an ounce of water, w4th enough of sulphuric acid to make 
it dissolve, make a convenient combination. One tea-spoonful 
can be given as a dose, or the quinine may be mixed with a little 
syrup, when given. This medicine must be continued until the chills 
disappear, and as there is no trembling, but simple coldness of the 
feet and hands, and paleness of the lips, much close observation is 
necessary to detect this form of ague. Remitting bilious fever not 
unfrequently occurs in young children, which is different from other 
fevers to which they are subject, that remit more than in adults. 
To properly discriminate between them, the localities in which they 
live, or were born, must come into consideration. 

Diarrhea. 

The symptoms of this complaint are a precarious appetite, or 
none at all; thirst; tongue loaded, being white or yellow, with some- 
times the sides and tip red ; apthse, flatulency, acidity, and griping. 
Soon emaciation is added. 

The stools may be feculent at first, only very liquid; but they 
soon begin to be charged with mucus, and they consist often solely 
of mucus, which appears like jelly, quite transparent, or lying at 
the bottom of the vessel like semi-transparent mucilage. This ex- 
cess of mucus may be connected with an inflammatory state, or 
a highly irritable state of the mucous follicles, and with a super- 
abundant mucus in the stomach and bowels ; and this latter is evi- 
denced by what is vomited and by what passes from the bowels. 



524 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Worms may cause this mucous diarrhea. The stools are some- 
times of a bright green or a grass green color, and the looseness 
has been called bilious. This is accompanied by irritation of the 
bowels, especially of that part into which the bile ducts open. 

Yellow and frothy, or very green stools, with pain in belly, are 
signs of inflammation of bowels. Derangement of the liver is usu- 
ally attended with dark brown motions, or even black, like pitchy 
and very offensive. 

Prolapse of the Anus or Bowel 

is not unfrequent. Here a large portion of the membrane of the 
bowel is protruded, which may inflame, ulcerate, or become gan- 
grenous. Blood is at times discharged from the bowels. 

In diarrhea, the state may degenerate into a chronic form, and 
may depend on chronic disease in the mucous membrane of the 
bowel ; or it may depend on a want of tone, or habitual derange- 
ment of function ; and when long established, it may be difiicult to 
remove, while children who have suffered are liable to a recurrence 
on committing any errors in diet. 

Treatment. — Diet is the first point to attend to, often the sole 
one necessary ; food should be in small quantity, of least stimulat- 
ing quality, easy of digestion, leaving as little residue as possible. 

In the recent stage, gum-water, barley-water, slightly sweetened, 
or both mixed, form both food and drink. Then arrowroot, made 
thin, may next be given, and is very good food, being little liable 
to become acescent ; but arrowroot is not usually liked by children. 

Milk, or bread and milk, or the breast-milk even, usually dis- 
agrees. Rice is a chief article of diet ; it leaves but little excre- 
mentitious matter ; it must be thoroughly boiled, and may be 
moistened with broth .or water. Then light broths — chicken broth; 
and then, if the child is old enough, chicken itself, with rice, or 
some of the gravy of roast mutton, with rice. 

Vegetables must be avoided, also fruits ; also veal, lamb, or fish. 

Keep the surface warm ; a flannel swathe round the abdomen ; 
fomentation, friction ; change the air. 

As to medicines, the question which first arises is, Shall we begin 
with an aperient, to clear away offending matter, or with astrin- 
gents, to stop the stools at once ? 

We may use aperients when the diarrhea is recent, when it oc- 



PROLAPSE OF THE ANUS OR BOWEL 525 

curs in connection with an overloaded state of the bowels, is ac- 
companied by feculent discharges in full, overfed children, and in 
cases attended with much fever ; but when the infant is young, 
and the evacuations profuse, we should give astringents, etc.-, im- 
mediately. 

Opium and the alkalies are the remedies indicated — carbonates 
of potash or soda, then the compound powder of chalk, and all 
combined with opium. 

When there is acidity, the chalk mixture; this acidity is known 
by the light green and watery evacuations, by the smell, by pieces 
of curd appearing in the stools, and by the green color becoming 
more vivid on standing ; by a sour smell of vomited matters, and 
the curd in them, and by a dense white coat on the tongue, which 
is a stratum of milk — coagulum. 

For bearing down, five or six grains of carbonate of soda or of 
potash, with one drop of tincture of opium, in two ounces of starch 
mucilage as an injection, is often effectual. 

This mixture is a good one : 

No. 232. Cinnamon-water 1 oz. 

Mint-water -J oz. 

Carbonate of soda, or of. ) ^ ^ 

Compound chalk powder j ° 

Tincture of opium 6 drops. 

Syrup 2 drs. 

Mix. 

Give 60 to 120 drops, three or four times a day, according to 
the age and the number of stools. 

If the looseness do not yield, we must add to the mixture two 
drachms of the tincture of kino, or of catechu, or of both, instead 
of the half ounce of mint-water. 

Kino may be given, even when there is some inflammatory dis- 
position left. It Ttill restrain the over-secretion of glands, and 
will check diarrhea ; but it does not induce a tendency to costive- 
ness afterward. 

When the stools are loaded with much mucus, then we should 
add small doses of ipecacuanha, or give some at night, as in Do- 
ver's powder. 

Diarrhea, then, ought to be arrested when exhaustion is pro- 
duced ; but we must be very cautious when it is of long standing, 
and does not seem to be doing harm, as in teething, or when the 
looseness seems to be the result and accompaniment of infiamma- 



526 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

tion, in which latter case it may do good by reducing or carrying 
ofi' the inflammation. 

The remedies are the chalk mixture, with or without opium, to 
which kino and catechu may be added, if the looseness do not 
yield; but on any heat or fever arising, the astringents must be 
discontinued, and fever medicines given, fomentations used, etc. 

When the bowxl comes down, return it gently, and throw up an 
ounce or two of lime-water, and give brown sugar or molasses for 
diet, to make the evacuations soft. As the health returns, the 
bowel will no longer protrude. When convalescent, the bitter in- 
fusions are useful. 

The term weaning rash has been applied both to indigestion and 
diarrhea, and must be treated as above stated. 

Worms in Children. (See Worms.) 

Croup, True and Spurious. 

This is most common between the first and tenth year, and sel- 
dom occurs after puberty. It is an inflammation of the voice-pipe 
(larynx) and of the air-pipes (trachea and bronchi), and it ends 
by forming a membrane on the inner surface of these tubes. 

The organ of voice has a chink called glottis, the size of which 
remains nearly equally narrow up to twelve years of age ; after 
puberty, this chink enlarges considerably and suddenly in the 
male, in the proportion of ten to five ; in the female, of seven to 
five. The limit of the period of occurrence of this serious disease 
is thus marked. 

Some families are much affected with croup, and it is very rife 
in some damp, cold situations. 

Once attacked, there is a liability to a recurrence on slight 
causes ; but those weaned are more liable than suckling children. 
During the north and easterly winds, and at the end of winter and 
spring, it is frequent. 

Symptoms — are those of common catarrh, with hoarseness and 
rough cough. The attack is sometimes sudden, but hoarseness 
and cough are suspicious when there is any reason to suspect an 
attack of croup. A single cough, as if the sound came through a 
brazen trumpet, may be the first sign; the voice becomes sharp 
and peculiar, the breathing loud, difficult, labored, and, during in- 



CROUP, TRUE AND SPURIOUS. 527 

spirations (the drawing of the breath), there is a crowing sound; 
the face is swelled, red ; eyes suffused ; skin hot, pulse quick and 
hard to the feel; thirst, restlessness; the child feels an obstruc- 
tion to breathing in its throat. 

After a longer or shorter time, the fit subsides ; then, if no relief 
be obtained, the breathing becomes more labored and wheezing, Ihe 
cough hoarser and more stifling, the countenance pale or livid ; 
the skin becomes cold and clammy ; dark, bad-smelling stools are 
ejected; coma or convulsions may terminate the attack; or the 
child may, after great efforts, throw up portions of a white mem- 
brane with some matter. Death may take place between the third 
and fifth day ; or the disease may become chronic, and continue for 
two or three weeks. 

A sudden spasm may cause suffocation. 

Stretching the neck by throwing the head backward, seems to 
give some relief. * 

Diphtheria may be mistaken for this disease, but the history and 
presence of thrush will show the former. 

Hysteria may simulate croup; but the former disease attacks 
only adults. 

All diseases affecting the larynx (voice-pipe) are attended with 
spasmodic signs, occurring in fits ; hence the origin of spasmodic 
or spurious croup. 

The distinctions may be thus laid down : 

True Croup. Bastard, or Spurious Croup. 

Catarrhal signs always ; sneez- A fit, often occurring sq^veral 
ing, riinning from the nose; cough times a day, when the child is in 
slight at times — short, but always perfect health; crying, laughing; 
hoarse ; trumpet-toned cough ; hiss- awaking from sleep on any excite- 
ing inspiration during the fit ; face ment. The spasm of the glottis 
swollen, purple ; eye livid, pro- terminates in a long-drawn, noisy 
truding ; lips livid or blue, and the inspiration, and then the child ap- 
signs, of course, as above detailed, pears as well as ever. The attacks 
The true croup depends on in- are sudden, but when they occur 
flammation; and it is a much more at night, a mistake might occur, 
dangerous disease than the spuri- Between the fits, true croup is 
ous. marked by the continuance of the 

suppressed voice, peculiar breath- 
ing, whereas, in spurious croup^ 
these soon cease after the fit. 



528 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Treatment. — An emetic is the first remedy. Give from one to 
three tea-spoonfuls, according to the age, of the following mixture, 
every quarter of an hour until the child vomits : 

No. 233. Distilled water li oz. 

Tartar emetic 1 gr. 

Syrup 1 oz. 

Mix. 

To this, half an ounce of ipecacuanha wine may be added, if it 
is at hand ; if not, do not wait. 

Then, if there is fever, hot skin, etc., apply leeches to the top 
of the chest-bone, and keep up a feeling of sickness by giving a 
drachm of the emetic mixture every half hour or hour, or second 
hour, and give two grains of calomel every third hour ; also place 
the legs in a bath at 98 or 100 degrees of temperature. If, after 
two or three doses of the calomel, the bowels are not open, give 
castor-jil, one, two, or more drachms. The breathing becomes less 
laborious, and the cough looser than before ; then we must observe 
a low diet, and keep the sufferer in a warm air. 

If we do not see the attack in its early stage, we must still ex- 
cite vomiting, keep up nausea, and give calomel in three-grain doses 
every third hour. Blisters to the chest-bone are here useful. 

If the child is cold and sinking, we must give ammonia, wine, 
and burnt brandy ; and children despaired of have recovered in a 
surprising manner. 

An operation has been proposed, but it is useless, as the mem- 
brane extends too low to allow of success. 

Dr. Kemble has met with great success, and yet never bleeds 
nor blisters. He confines the child to a warm atmosphere and an 
uniform temperature, gives an emetic, and, in an hour after the 
vomiting, this : 

No. 234. Powdered valerian root 2 drs. 

Oxymel of squills 1 oz. 

Tincture of opium 20 drops. 

Distilled water 1 oz. 

Mix. 

To a child from two to five years old, he gives a tea-spoonful 
every hour ; to one from five to eight, a tea-spoonful every forty- 
five minutes; and the symptoms are fo*und to give way in ten 
or twelve hours, never continuing longer than forty-eight hours. 
After subsiding, a brisk dose of calomel and jalap should be given. 

In bastard croup, if the breathing is very much impeded, an 



THE MEASLES— RUBEOLA. 529 

emetic, or the nauseating mixtures ; and we must prevent a recur- 
rence by keeping in an uniform temperature, rubbing tartar emetic 
ointment or liniment on the spine at the neck, bj keeping the bowels 
open, by shower bath, and by occasional or regular doses of carbo- 
nates of soda or potash, in some one of the simple bitter infusions. 

[The various inflammations of lungs, stomach, bowels, kidneys, 
or bladder may occur in children as well as in grown-up persons 
(the treatment of those diseases has been detailed in preceding 
pages), only we may adapt our remedies to the age and strength 
of the patient, and to the violence of the symptoms.] 

The Measles — Rubeola. 

This is an eruptive fever, affecting the mucous membrane of the 
air passages, with a red rash over the body, the rash appearing in 
about three days' time. 

Symptoms. — Languor, shivering, heat of skin, thirst, and the 
usual signs of fever. Common catarrh seems to be threatened^ 
but there is a dry, hoarse cough, at times croupy; frequent sneez- 
ing, suffused and watery eyes, feverish face, heat and chills, quick 
pulse, scanty urine, hot and dry skin ; sometimes vomiting and 
purging, at others the bowels are costive ; delirium in some cases, 
and the patient is worse toward evening. In three or four days — 
in rare cases, in seven or eight days — round red dots appear oa 
the forehead and face, afterward upon the body and limbs. On 
the fifth day the w^hole body is usually covered with the eruption; 
this declines on the sixth day, and by the tenth, it usually disap- 
pears. The rash gives a sensation of hardness to the finger ; sep- 
arate elevations may be felt, which run together into patches of 
an irregular semi-circular form. The skin between them retains itg 
natural hue, and the patches are of a lighter color ; but the color 
may change to a darker color, so as to constitute the black measles, 
which latter are of unfavorable tendency. 

The patches are at last covered with scales, which become de- 
tached, and cause a troublesome itching. 

The fever, in favorable cases, abates as the erup'tion appears,, 
though cough may remain troublesome. 

The measles are subjected to certain laws in a very remarkable 
manner : 

34 



530 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

1st. Thej usually attack only in the commencement of life. 

2d. They occur but once in the same individual, though there 
are some rare exceptions to these two rules. 

3d. They run a certain definite course as to order of symptoms, 
and as to their duration. 

4th. They afford the only certain examples of disease being 
propagated by contagion, though they occur as epidemics at cer- 
tain seasons of the year, namely, spring and beginning of summer, 
in which latter case they spread independently of contagion. 

5th. They have the power of suspending the action of other epi- 
demics ; thus epidemics of measles and small-pox may occur simul- 
taneously, but the small-pox, after it has been received into the 
constitution, may be suspended by an invasion of measles, and then 
resume its course after the measles have terminated their course. 

Measles are not dangerous in themselves, but they may be com- 
plicated with inflammation in the brain or chest, but chiefly in the 
chest, when imminent danger may very soon be incurred; then 
measles are apt to leave what are commonly called the dregs of the 
measles, and they may assume the form of ophthalmia, scrofula, 
diarrhea, or consumption. 

The latent period in measles — that is, the time between the at- 
tack and exposure to the cause — is from ten to fourteen days. 

The character of the epidemic may be malignant. 

Treatment. — When the course is regular, and the fever moder- 
ate, the treatment is very simple ; diluent drinks, some fever medi- 
cines, with the addition of some tincture of opium and ipecacuanha 
wine ; or this : 

No. 235. Distilled water 1 oz 

Mucilage of gum arabic 2" ^^• 

Ipecacuanha wine 2 drs. 

Syrup of white poppies 1 dr. 

Mix. 

A tea-spoonful every second or third hour, or according to the 
cough. 

A very gentle aperient may be given, if the bowels are confined ; 
if not, we had better give neither purgatives nor aperients. Every 
thing heating should be avoided, and stimulants must especially be 
avoided. They are often erroneously given, "to strike out the 
eruption, and drive it from the heart," as it is said. 

The body, if there is much heat before the eruption, may be 



THE MEASLES— RUBEOLA. 631 

sponged with warm vinegar and water ; and this process may be 
repeated at the period when the skin begins to scale off, which scal- 
ing off usually causes much itching. 

We must jealously watch the breathing for any symptoms of in- 
flammation of the chest or in the head. Then the treatment recom- 
mended for those diseases must be immediately begun, and carried 
out. The chief, if not sole danger, in this disease, arises from in- 
flammation attacking the chest, for the tendency in measles is to 
inflammation. We must closely watch the breathing, as shown by 
the nostrils in infants, and by the quick respiration in children 
There is a difficulty of breathing arising from irritation, which will 
pass away, as well as a difficulty of breathing from inflammation ; 
but the former is not always the same, and there will be an alterna- 
tion of relief with great oppression, and the erect position does not 
relieve, and rest and sleep are often obtained ; not so in inflammation. 

Here no time is to be lost ; and blood should be taken by bleed- 
ing and encouraging the oozing of the leech-bites, and giving the 
following powders : 

No. 236. Calomel 20 grs. 

Tartar emetic 1 gr. 

Powdered gum arable 20 grs. 

Rub well, and divide into twelve powders. Give one every second 
or third hour, till the chest symptoms seem relieved and the breath- 
ing easy; then discontinue the powders. 

Saline medicines may be given, and drinks. 

The skin in infants and young children is so very delicate that 
blisters should not be apphed; for they sometimes give rise to 
nasty sores afterward ; but this liniment may be rubbed in : 

No. 237. Camphor liniment, or ammonia liniment. 2 oz. 

Spirits of turpentine 1 dr. 

Mix. 

Sop a fold or two of linen or lint in this fluid, which must have 
been made warm by setting the bottle in hot water, and put it on 
the chest, of the size and shape necessary. In twenty minutes a 
sufficient redness and effect will be produced. 

Sometimes, when a child has been exposed to the contagion, and 
has had the usual precursor, catarrhal symptoms, the eruption doea 
not appear at the proper time, but a state of sleep, or rather coma, 
comes on ; the warm bath, with a table-spoonful of mustard flour 
thrown in, has caused the eruption to appear and the coma to vanish. 



532 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

A dose of calomel lias done the same thing. 

In one case, the breathing was intensely difficult, the face livid 
red, the lips dark red, and I ordered an emetic, to the immediate 
relief of all the symptoms, and ultimate recovery. 

If little dark spots appear, like flea-bites, and there seems to 
exist a state of debility, then give wine, and this mixture : 

No. 238. Mint-water 1| oz. 

Sal volatile 30 drops. 

Spirits of sweet niter 60 drops. 

Syrup 1 oz. 

Mix. . 

A tea-spoonful every second or third hour. 

A looseness of the bowels may come on ; this must be checked, 
and finally stopped, in the way mentioned in Diarrhea. 

Scaly ulcerations behind the ears may be a consequence of the 
measles in some scrofulous constitutions. Here give gentle aper- 
ients, carbonate of soda with infusion of gentian ; and if much 
debility exist, sal volatile may be added. Apply spermaceti oint- 
ment. 

During convalescence the skin must be protected from the cold 
by flannel. 

Some cases of measles have occurred where there have been no 
signs of catarrh, and others where the rash has been of a dark 
color ; this latter has been called the black measles. 

If the inflammatory symptoms have been efi'ectually removed, 
and the bowels kept free, there will be little chance of sufi"ering 
from the " dregs of the measles." 

Vaccination, or Cow-pox. 

The history of this extraordinary discovery need not here be 
detailed. The mode in which vaccination is performed is this : 
After selecting a healthy child, who has the pock in its proper 
stage, we dip the point of a blunt lancet into one of the cells of 
the pock, and then gently insinuate the point into the arm of the 
child to be vaccinated, choosing a spot a little below the shoulder, 
where the dress, or any thing else, is least likely to rub or inter- 
fere. Here make two or three scratches ; a drop of blood may 
make its appearance, but it is better if it do not ; the vaccine fluid 
is thus introduced under the outer skin of the child by letting the 



VACCINATION, OR COW-POX. 533 

lancet be wiped quite clean by the skin. If we use the dried fluid 
from points or glasses, we wet either for a moment with a drop or 
two of cold water, scrape off the vaccine matter with the lancet's 
point, and use it as stated. 

Crusts of vaccine pocks are sometimes used ; they must be wet,- 
ted or dissolved partly in a drop or two of water. 

About the third or fourth day, a small hard spot ought to be felt 
under the skin, like a pin's head ; this forms a red pimple, hard to 
the touch, and slightly raised above the skin. A vesicle becomes 
apparent to the eye. about the fifth or sixth day, and the pimple 
enlarges. It is now circular in form, with its center depressed and 
edges raised, and it is sometimes indented by one or two concentric 
furrows, resembling a w^orm coiled under the skin. The depressed 
center is characteristic. 

It increases gradually until the tenth or eleventh day, to the 
diameter of about four lines. The size varies; for if two or three 
punctures have been made near each other, two or three vesicles 
form, which coalesce and run into each other. The color of the 
vesicle is at first a light pink, Avhich changes to a pearl color. The 
center is darker than the margin, which is swollen and shining. 
The vesicle consists of a number of little cells, filled with a clear 
lymph, and these cells communicate with each other. 

On the eighth or ninth day an inflamed ring forms round the 
base, which, on the tenth, is from one to two inches in diameter. 
This areola is red, hard, and swollen. The redness continues for 
a day or two, then begins to fade, generally from the center to the 
circumference, sometimes forming two or three concentric rings. 

After the tenth day the vesicle declines, the center becoming 
brown, and then a hard, smooth crust, of a dark mahogany color, 
forms, having a concave surface. 

About the twentieth day the crust falls off, leaving a permanent 
circular scar, a little depressed, and marked with small pits, as 
numerous as the cells were of the vesicle. 

The general symptoms are very slight — restlessness, shivering, 
thirst, headache, peevishness, drowsiness — but they are of no con- 
sequence. 

Some make several punctures, in order to secure the effect; I 
rely on two only — one in each arm ; but am very particular as to 
the selection of the virus, and in the examination of the child to 
be vaccinated ; for I make it a rule to postpone the vaccination if 



534 AMEEICAN HOUSEHOLD BOOK OF MEDICINE. 

a tooth be coming out, or if there is any eruption on the body, or 
a diarrhea, or evidence of any irritation in the body anywhere ; 
for if there be, I believe the patient will not be secure from small- 
pox. The most favorable time for vaccinating is between the ages 
of six weeks and two months ; the late Dr. G. Gregory recommends 
the fourth month, but always before teething begins. This period 
is prior to the period of teething, and subsequent to the extreme 
irritability of first infancy ; but we may vaccinate, without risk, 
immediately after birth, if small-pox be near at hand. 

And with respect to the state of the pustule, that is, to the day 
when we may take lymph from it, it is now generally agreed that 
we should open the vesicle on the eighth day, or even a day or 
two later, provided the margin or areola, previously described, has 
not appeared. 

We may preserve this lymph by receiving it on a small square 
of glass, which we allow to dry; then covering it with another sim- 
ilar square of glass, fold both up in a piece of moistened bladder 
or gold-beater's skin. For more immediate use, the lymph may be 
taken upon thin-pointed blades of quill or ivory ; these should be 
charged with lymph two or three times, being allowed to dry be- 
tween each charging, and then inclosed into a packet with gold- 
beater's skin. 

Another way of vaccinating is by the cow-pox crust, which is 
perhaps more certain than either the glasses or points ; this crust 
is probably the actual lymph in a concentrated state ; the crust 
must be kept dry, in a well-stopped phial. The surest way of vac- 
cinating is by having the two children in presence, and doing it at 
once ; if not, the lymph may be carried on the lancet's point for a 
few hours — three or four, but not longer. The crust is the next 
best. 

Great anxiety is naturally felt as to the protection afforded from 
small-pox, and as to whether the constitution has been sufficiently 
affected by the lymph ; and Dr. Bryce has discovered a test, which 
was at one time almost constantly put in practice. He found that 
" if during the regular progress of cow-pox, a second inoculation 
or vaccination be performed about the end of the fifth, or begin- 
ning of the sixth day after the first operation — that is, between 
thh'ty-six and forty-eight hours before the areola or margin of the 
first begins to appear — the affection produced by this second in- 
oculation will be accelerated in its progress so as to arrive at 



VACCINATION, OR COW-POX. 535 

maturity, and again fade at nearly the same time as tlie affection 
arising from the first inoculation, and that this will take place al- 
though the constitutional affection be so slight as to otherwise pass 
notice." So that we must take some lymph on the fifth day after 
a vaccination, in which all is going on in the regular course, and 
insert this lymph into the opposite arm in one or two places, "^nd 
we shall see that this second operation will be followed by a mi- 
nute vesicle on the third or fourth day — that is, on the eighth or 
ninth from the date of the first — which vesicle will be immediately 
afterward surrounded by an areola, and will become, on the fifth 
day of its own existence, an exact miniature of the first on its tenth 
day ; both will have finished their course at the same period, that 
being usually the thirteenth day from the first inoculation, and 
eight from the second. Dr. Maunsell, from whom this description 
is taken, says : " The rationale of the acceleration, which thus 
takes place in the second vesicle, may be explained in a few words. 
The phenomena (circumstances) of the ordinary cow-pox before 
the eighth day, or, in other words, until the appearance of the 
areola (inflamed margin), are strictly local ; when this appears, we 
may look upon it as a visible sign of the specific fever (or, per- 
haps, we should rather say action) being in operation in the sj-s- 
tem ; and as a consequence of this general action, we find that a 
specific areola appears around any local vesicle of the same dis- 
ease that may at the same time actually exist upon the surface of 
the body, although that vesicle may not be in existence sufficiently 
long, according to the known laws of the disease, to be itself the 
cause of this phenomenon. The latest period at which we can 
expect this test to succeed is from thirty-six to forty-eight hours 
before the appearance of the first areola, as it is necessary that 
the secondary affection may have proceeded some length, and that 
a small vesicle containing virus (lymph) may have been formed by 
It before the constitutional action from the first inoculation begins; 
otherwise no areola, but merely a slight degree of hardness, will 
take place from the second puncture. We defer it to the latest 
period in order to afford the strongest possible contrast between the 
progress of the two inoculations. 

" This test-plan should always be tried, though we must not 
assume that all is wrong if it fail, since from unskillfulness in the 
operator, or from some accidental friction, which no one vvill own, 
the second vaccination may not take effect a^t all. 



536 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

" But neither first nor second vaccination may take effect, from 
some peculiarity of constitution, rendering the child insensible to 
the action of the lymph; then, after a second unsuccessful trial, 
We must leave the child to its chance for six or seven years, when 
some change may have taken place, and the vaccination then be- 
come successful. 

" Dr. Sonderland, more than twenty years ago, proved the iden- 
tity between the contagion of the cow-pox and that of human small- 
pox ; and that cow-pox in the cow is simply small-pox in man, and 
may be produced in that animal at will by the variolous contagion. 
This would explain the protective power of cow-pox. They are 
merely modifications of one another. All previous uncertainty 
with respect to the ceasing of the protective power^ and to the 
degeneration in quality of vaccine matter, must now cease. Dr. 
Sonderland says no disease in the gaseous form can thus be com- 
municated to the lower animals with advantage ; perhaps a pro- 
tective measure may thus be discovered ultimately against other 
diseases, as scarlet fever, measles, yellow fever, and plague, each 
specific poison being modified by passing through the system of 
an animal." 

If this be true, a great desideratum in this disorder would be 
gained. 

Dr. Gr. Gregory recommends revaccination at the interval of 
one, two, or three years, if Bryce's test have failed, or the cow- 
pox itself has. not been satisfactory ; he recommends five places to 
be inoculated, and says the lymph of a fifth-day vesicle never 
fails. 

Until the eighth day the constitution does not seem to sympa- 
thize ; nor even then, in most cases. There may be restlessness, 
disordered bowels, heat of skin, and disturbed night's rest, but 
medicines are seldom necessary. 

The irregularities or anomalies of cow-pox are numerous. In 
some cases a red, itching vesicle is formed, is rubbed, and a small 
needle-shaped or conical-shaped pustule is formed ; the areola is 
irregular, and the lymph is not transparent. The surrounding 
scab is small, and drops off prematurely, instead of dropping off 
between the eighteenth and twenty-first day. 

A perfect vaccine scar should be small, circular, and marked 
with radiations and indentations ; but many scars disappear as life 
advances. But if all has gone on right to the eighth day, the virus 



TINEA CAPITIS— RINGWORM. 637 

lias taken full effect, and all that happens afterward is immaterial 
in respect to the security of the child. So the scar left is not to 
be depended upon a^ evidence of security. The seal) leaves an 
ulcer sometimes, when the pock has not been of the true kind. 

With respect to the vexed question of the failures to protect in 
the vaccine lymph, it is now agreed that, whether from idiosyn- 
crasy (peculiarity) of constitution, or some other cause, small-pox 
has repeatedly occurred after vaccination; but still the benefit de- 
rived in the vast majority of cases is incontestable ; nor have I 
encountered one fatal case of small-pox after cow-pox, though I 
have heard and read of some, yet I have had under my care sev- 
eral instances of confluent small-pox after vaccination, where the 
symptoms were violent and threatening in the earlier period ; but 
I have found the usually dangerous secondary fever either omitted 
altogether, or else rendered very mild ; nor have I ever seen any 
one scarred after the attack ; and my confirmed opinion is, that it 
is next to an act of madness to reject the almost certainty of 
benefit and protection to be derived from vaccination on account 
of a few isolated cases of failure. 

Still, I am not averse to the practice of revaccination, about the 
ages of seven, fourteen, and twenty- one, if it were considered de- 
sirable by any persons who may have misgivings about their being 
sufficiently protected from small-pox. 

When the first instances of small-pox after cow-pox were pub- 
lished, a reaction arose in favor of the old practice of inoculation 
with small-pox virus, but I trust there are few to be now met with 
who would prefer this latter to vaccination. And to those few I 
would suggest that the inoculated small-pox at times proves both 
severe and fatal, whereas this can never be alleged against vacci- 
nation ; and I would also suggest, that, by inoculating with the 
small-pox virus, danger is incurred, not only by the person inocu- 
lated, but by all who may live near or come in contact with the 
patient, while the dangerous disease is propagated, and so might 
become fatal to many. 

Tinea Capitis — Ringworm. 

This is an inflammation of the hair follicles, which produces a 
peculiar yellowish substance, surrounding the cylinder of the hair, 
and is seen through the outer skin as a minute circular spot, not 



538 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

raised above the level of the skin. This yellow substance escapes 
from the follicles of the hair upon the surface of the outer or scarf 
skiuj and dries into yellow friable crusts, forming a distinct cup, 
with an inverted border, around the base of each hair. When 
many of these cups join together, they resemble the cells of a 
honeycomb. 

The first intimation of the coming mischief is in the appearance 
of the hair on the diseased spot ; it becomes thin, discolored, 
twisted, and is at last thrown off, in consequence of the disease 
extending to the deep-seated structure. The spot is left bald, and 
the disease has probably involved all the textures down to the bone. 

The scalp is the chosen site, but the disorder may extend to the 
face, neck, and body. It is highly contagious, and easily commu- 
nicable by contact. 

Children are usually the subjects of this disease, and such chil- 
dren are often of an inferior degree, or of stunted intellect. If the 
irritation continue long, the glands in the neck swell, a weakly 
and unhealthy system and a scrofulous taint predisposes, and the 
disease, if uncured, may last for years, and cause serious damage. 

Contagion is the exciting cause, and towels, combs, brushes, hats 
or caps afford a ready means of propagation, especially in large 
schools, where the greatest difficulty is found to eradicate it. 

The yellow substance in the crust, it is said, has been proved to 
be an organic structure of simple growth, and resembles those 
inferior members of the vegetable world denominated mold. The 
name of mycoderm has been given to this parasite ; and its or- 
ganization is supposed to be vegetable, because this mycodermis 
consists of a number of cells, capable of extending themselves by 
the ordinary process of multiplication. But the truth is, that the 
vesicular organization is common to animals as well as to vege- 
tables, being the only form that manifests itself at an early pe- 
riod of development in either kingdom. And Professor Carpenter 
deems it an arbitrary assumption to speak of this disorder as pro- 
duced by the growth of a vegetable within an animal body. The 
parasitic growth has roots and branches, smooth, cylindrical, and 
transparent little tubes ; its roots are attached to the yellow cap- 
sule ; its stem and branches extend inward toward the center of 
the capsule, and constitute the whitish-gray and porous contents 
of the crust. Although the mycoderm may not be of vegetable 
origin, it is a structure of a low type. 



TINEA CAPITIS— RINGWORM 539 

Otlier diseases may be mistaken for this ; but we must look to 
the cup-shaped crusts, of a bright yellow color, and dispersed; but 
the most characteristic appearance, and one which distinguishes it 
from all other diseases of the scalp, is the discolored, dry, and 
twisted appearance of all the hairs, arising from the diseased fol- 
licles. On examination, these hairs will be found quite loose, if 
gently drawn by the forceps. 

Treatment. — We must do our utmost to cure and prevent this 
disease ; and the first and chief point to look to is, to see that in 
schools, or anywhere else, a perfect insulation be maintained of the 
affected child, and care taken that towels, caps, etc., shall be used 
solely by the patient. Some public schools have been infested for 
years with this complaint, which has at last been rooted out solely 
by great watchfulness and organization. 

The general remedies are those adapted to elicit high tone and 
vigor, and they need not be detailed. 

The local applications have been numerous, in proportion to the 
continual failures; but Dr. Wigan proposes a remedy, which he 
says has never failed in curing, if rightly apphed, and Avhich, also, 
has the additional advantage of acting as a detector of this disease 
in its early stage, when it is most important to treat it, since we 
have already said that when this disease has existed long, the whole 
of the scalp, down to the very skull itself, becomes affected, and 
the disease incurable. 

I have verified the statements of Dr. Wigan, and have watched 
with much interest the progress, amendment, and cure of many a 
case of ringworm in a very large public school ; and I have also 
seen the application used as a detector with great success. It ap- 
pears that Dr. Wigan, had been, as many of his compeers, baffled 
in his treatment of this obstinate disorder for many years, until, 
at last, he made the discovery of a cure. He having successfully 
tried the remedy, printed many circulars, and distributed them 
freely about. 

When we reflect on the hitherto intractable nature of this con- 
tagious and tedious disease, and on the farrago of remedies which 
has been boasted of by different practitioners, we shall be delighted 
to try the following mode of curing this affection : 

The disease should first be identified with a powerful lens, as 
many mistakes have been made. Scaly tetter (psoriasis), and sev- 
eral other disorders of the scalp may be mistaken for ringworm; 



540 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

but'the mode of distinguishing the ringworm from all other erup- 
tions of the scalp has been related. 

If, then, we find there is any concomitant disorder with the ring- 
worm, it must first be removed; then the he^ad must be shaved, ex- 
cept a few locks of hair in front, if desired. If any razor-cut have 
been inflicted, it must be healed before we go further ; then apply, 
by means of a short, soft shaving-brush, all over the head, strong 
pyroligneous acid, diluted with one-third its volume of distilled 
water. I have seen it used undiluted, but the application is rather 
a sharp one. Keep the head wet with it for two minutes, when 
slight and transient pain" will be felt at the diseased spots, which 
are immediately rendered visible, though they could not previously 
be distinguished. These spots become of a very bright red, while 
the healthy scalp is not at all afi'ected, unless in particular instances, 
where the skin is fine and delicate ; for, in such habits, the stimulus 
of the acid causes universal reddening ; then the acid should be 
tried again in a more diluted state. 

Every spot is thus detected, and the extent of the disease as- 
certained. 

A second and a third application, with intervals of three or four 
days, will complete the cure; but we must soak the parts with the 
acid for fifteen minutes, or else gently rub it in. Once doing so 
is sometimes sufficient. A thick scab is generally the result of 
this process, and this scab should not hastily be removed. In 
seven or ten days, the scab rises from the scalp, supported by the 
new hair; then introduce a fine pair of scissors under it, and cut it 
ofi", when the skin at the bottom will be found clean and healthy. 
Examine by the lens, and if there are any yellowish spots, or any 
suspicious appearances, repeat the application of the acid. We 
should likewise examine the state of the hair around the patch, 
and indeed all over the head ; if any are loose or altered in ap- 
pearance, the disease is there. When the hair is very thin on any 
point, we must apply the detector acid. 

These applications of acid should be done by a medical man; 
but if there be no one at hand, any tolerably clever person may 
apply them, by attending to the foregoing directions. 

Ringworm on any other part of the body than the head never 
requires more than one application for its cure. The most em- 
barrassing cases are those which have been under professional 
care, and where many irritating ointments, etc., had been pre- 



TINEA CAPITIS— RINGWORM. 641 

scribed. Here tlie irritation must first be subdued before we try 
the acid — poultices, hot or cold, gentle aperients, waiting a few 



If on the first examination (after the test of the acid) there be 
found only a single spot of slight extent, to prevent contagion, 
touch the spot with kali purum (caustic potassa), so slightly as to 
give no pain. This is effectual ; a slight scar is formed, and when 
the slough separates, the hair will not grow again for some time; 
but there is no fear of its being reestablished in a few months, and 
in the mean time all apprehension is at an end. 

Dr. Wigan's detector acid is the concentrated pyroligneous acid, 
diluted with three times its weight of water. On its application, 
a number of spots, which looked perfectly healthy, become red 
patches. They are indications that infection had been taken, but 
had not gone through its stages, which period he (Dr. W.) believes 
to be, after great experience, eight days. 

Having thus ascertained the numbers and position of your en- 
emy, your course is clear. One vigorous assault, and there is an 
end of the matter. With a piece of fine sponge, either tied to the 
end of a stick or held in a pair of silver sugar-tongs, each spot is 
to be thoroughly imbued with the concentrated acid for the space 
of three or four minutes, and the business is finished. 

The only reason for seeing the patient again is, that a crust 
forms, and an appearance of worsening takes place. This crust 
is pushed up with the hair, which soon sprouts again if the erup- 
tion be recent; and as soon as a fine pair of scissors can be in- 
serted underneath, it should be removed, but not prematurely, 
lest a sore place be formed. More than one application of the 
acid is seldom necessary, when the above-stated preliminaries have 
been properly gone through on the shaved and tested head. 

The acid must not be continued too long, or the disease of the 
doctor will be produced; namely, an inflammation and eruption 
caused by the remedies applied. Then discontinue all applica- 
tions. 

For general treatment, nutritious, non-stimulant diet, with per- 
haps a grain of calomel at night, once a week or so, with a gentle 
aperient next morning, will be all that is necessary. 

The infant may labor at birth under certain morbid conditions, 
or it may sufi'er from accidents or from diseases peculiar to this 
period of their lives, or modified by circumstances peculiar to that 



542 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

period. The young mother should know something about them, 
although many of them can only be remedied by the surgeon and 
accoucher. We therefore proceed to describe some of those states. 

Still-born Children. 

Here the child may be born with no indication of life, except 
perhaps the pulsation in the navel cord, or a feeble action of the 
heart; or there may be ineffectual efforts at breathing, or the child 
may even cry faintly, yet strength may be wanting to establish the 
breathing. 

Much may be done to restore the life so nearly lost ; for we 
know that the heat of the new-born child is about three degrees 
less than that of the adult; hence it can exist longer without res- 
piration, wherefore nothing short of the most positive indications 
that the infant is dead should prevent us from persevering in our 
efforts to restore life ; and these efforts should be continued as 
long as the slightest attempt at motion of the respiratory organs 
is evinced, or the slightest pulsation of the heart continues. 

We observe the still-born infant under two conditions — one in 
which it is evidently feeble, mouth open and flaccid, limbs relaxed, 
and cord beating feebly or pulseless ; or the other, in which the 
child is of full, large plethoric habit, the face swollen and purple, 
the cord tense and beating strongly, as if there existed a state of 
apoplexy. 

Our treatment must vary according to these two sta>tes. Our 
first object is to remove all impediments to the passage of the air 
into the lungs. We place the child with mouth uncovered, and 
pass our finger into the back part of the mouth, so as to clear the 
passages and excite the respiratory efforts. 

The chest should be gently rubbed or slapped, and exposed to 
the cold air ; then the chest and soles of the feet must be rubbed 
with spirits, and the nostrils irritated with a feather, dipped in the 
spirits, or by holding the carbonate of ammonia (smelling salts) 
to the nose. The cord should not be tied and cut unless respira- 
tion be established. If the child be of full habit, and of swollen 
purple face, the circulation should be relieved by cutting the cord 
and allowing it to bleed. Two other means of resuscitation are 
put into requisition, which are inflation of the lungs and the warm 
bath. 



DEFORMITIES— TONGUE-TIED— HARE LIP. 543 

The inflation should be done very gently indeed, and the air 
should not be cold. Dr. Maunsell recommends that the operator 
should inflate with his own lips, and then gently press the chest, 
and repeat, so as to imitate the process of breathing. 

As to the warm bath, respiration may be set going, and a cry 
uttered immediately upon plunging the child into a bath of 100 
degrees of temperature. If motion be produced, withdraw the 
child, and rub with dry, warm flannel. By keeping the child in 
the bath the air is excluded, and the temperature so raised as to 
render it less capable of bearing the deprivation of air. 

Should the child continue to breathe feebly, and show an ina- 
bility to suck after animation has been restored, we must excite 
by friction on the surface ; we may stimulate the bowels by some 
castor-oil ; and if there be much rattle in the breathing, one gen- 
tle emetic may do good service. 

Deformities 

sometimes exist, but these must be left to the surgeon ; and some 
of the natural apertures may be closed, leading to a retention of 
the contents of the bowels or bladder. 

Some children are born with a round, compressible tumor on the 
lower part of the spine, varying in size from that of a nut to that 
of the closed fist. All the mother can do is to protect the swel- 
ling from pressure. 

Tongue-tied. 

Here the bridle to the tongue extends too near, or to the tip of 
the tongue, and the child can not suck. 

If the tip can be protruded beyond the lips, there is no tongue- 
tie. Where the tongue is tied, the bridle requires to be cut suf- 
ficiently ; but this seemingly trifling operation has been followed 
by serious events. 

Hare Lip. 

If this do not impede suckling or threaten life, it should not be 
operated on in early infancy. 

Deformed feet, and supernumerary toes or fingers, are met with. 
Operations should be postponed. 

Mother's marks come under the surgeon's attention. 



544 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Kuptures, also ; and they are only mentioned to give notice tliat 
such may exist. 

Injm^ies are often received during birth. Great blue or black- 
ish swellings may be visible, but they should not be meddled with, 
never opened, but some of the discutient spirit washes applied, 
which are prescribed elsewhere. 

The bones of the limbs are sometimes broken during birth, but 
the same treatment may be applied here, as in that of fractures in 
general. 

Palsy of the limbs may be induced by the use of the blunt hook 
during delivery; here nothing can be done. 

The Blue Disease — Cyanosis. 

The right and left cavities of the heart should, after birth, have 
no communication with each other, except through the lungs ; and 
a hole, which used to be open before birth, and which is a commu- 
nication between the right and left cavities, ought to close after 
birth. In some cases it does not ; and then the child's lips, cheeks, 
and nails are of a blue, purple, or leaden color, the skin is colder 
than it should be, and fits of difficult breathing come on, causing 
the blueness to deepen in color, the pulse to stop, and the feet to 
become cold. 

The child may recover frequently from these fits, but usually 
dies in one of them. The fits are caused by any thing which hur- 
ries the breathing or pulse. 

This disease may depend on the hole above alluded to being 
open, thus allowing the blue venous blood to mix with the bright 
arterial red blood ; still, cases of blueness have existed w^here there 
has been no open hole, and there has been no blueness, where the 
hole has remained open. There must, then, be some other cause 
or causes — causes which produce imperfect filling of the lungs. 

As to treatment, nothing can be done where the hole is still 
open ; and the subjects live a longer or shorter time, then die. 
Morgagni tells us of a girl who lived to her sixteenth year, with 
a hole open large enough to admit the passage of the little finger 
through it. 

As to the other causes, we must do as recommended for still- 
born children, and, during the fits, expose freely to cold air, sprinkle 
cold water on the face, etc. 



I ^•^ 




(jduM^^ue^ Md^. 



^OntRred,a£mrtlim tz ojiief CoF^irsss-^JSeo hv^SojT^'' W 



NINE-DAY FITS— ERYSIPELAS OF INFANTS. 545 

Nine-day Fits — Trismus Nascentium. 

In tlie West Indies and some tropical climates this is a very 
fatal disease. 

Within about nine days after birth — about the time the navel 
cord falls off — fits occur, called by nurses "black fits and whfte 
fits." The first often kills in from eight to thirty hours ; the second 
may continue three, five, or nine days. There are sometimes warn- 
ing symptoms — starting during sleep, a livid circle about the lips, 
puckering of the mouth, peculiar screeching, a smile during sleep. 
The stools may be regular and natural, or greenish, slimy, knotted. 

When the fit comes on, there are violent, irregular actions of the 
muscles of the limbs and face, recurring at uncertain intervals. In 
the black fits the spasms are more violent ; there is foaming at the 
mouth, thumbs turned into palms of the hands, the jaws closed, and 
any attempt to open them adds to the spasms ; the face and body 
swollen, and of a dark copper color ; during the intervals the mus- 
cles are stiff. 

In the white fits there is less violence ; the face is pale, and the 
body becomes quickly emaciated. Both are equally fatal. Such 
is Dr. Maunsell's excellent description. 

Treatment. — Here nothing satisfactory has been established, since 
the cause has not been agreed upon, some referring to the state of 
the navel, others to other causes. We, however, have reason to 
think that free ventilation and perfect cleanliness act efficiently as 
preventives. Dr. Brien gives us some hope from administering 
the eighth of a drop of laudanum every second hour, until the ef- 
fects of opium are produced — drowsiness, cessation of the spasms — 
and a grain and half of calomel every fifth or sixth hour up to the 
third time, with, intermediately, a large-sized tea-spoonful of cas- 
tor-oil, sometimes joined with a third part of spirits of turpentine. 
The warm bath has done no good. 

Erysipelas of Infants. 

This disease generally appears about the navel, but sometimes 
on the limbs and joints, as the ankle and wrist. 

Considerable danger attends on this affection, for it quickly runs 
into gangrene or the formation of matter. The concomitant fever 
is almost always typhoid. A dark red, shining' spot first appears, 
35 



546 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

"which assumes a purple color, without much swelling ; the skin is 
hard ; bladders are formed on the belly, and gangrene follows, 
which sweeps away a great part of the skin, and extends low down, 
destroying the parts in its course. Offensive, slimy stools, with 
great restlessness, and, at last, coma. 

It may attack immediately after birth. 

The issue is very doubtful, and would be altogether hopeless, 
were we not acquainted with the strong hold on life possessed by 
an infant, and with the wonderful efforts at reparation of injury of 
which it is capable. 

Treatment. — To change the air should be almost the first step ; 
then the milk must be looked to, if the mother secretes enough or 
not, or whether the milk is good, the mother healthy. If not, a 
wet nurse must be procured. If the child can not suck, give a tea- 
spoonful of white wine whey every hour or half hour. A gentle 
aperient must be given, and after this has operated, a quarter or a 
third of a grain of quinine, every three or four hours, with as much 
aromatic powder. Ammonia is recommended by some. 

Dust the part with starch powder or common flour, and if matter 
is forming, or gangrene threatened, foment or poultice with light 
bran, chamomile flowers, or the fermenting poultice. 

Abscesses 

sometimes form in the armpits, neck, or lower part of the leg in 
infants. A tumor forms, not painful, which becomes red, and a 
soft spot is observable. On letting the matter out, the abscess 
soon gets well, and little or no general treatment is requisite. 

Indueation of the Cellular Tissue. 

This disease attacks prematurely-born or feeble children, in 
whom the breathing has not been fully established, and commences 
usually in the feet, which become swollen, dry, hard, and cold. 
The skin may be of the natural color, or it may be livid or purple. 
The skin appears as if tightly stretched over the parts ; it is cold 
and hard, and pits but slightly on pressure. The disorder invades 
the body, the temperature of which is remarkably diminished. 
There is no attending fever. The child is restless, will not suck, 
and whines in a way which may be compared to the crying of mice. 



JAUNDICE OF INFANTS— PURULENT OPHTHALMIA. 547 

The breathing becomes more and more difficult, until death super- 
venes, usually within the fourth day, but sometimes so late as the 
second or third week. We can entertain but little hope of recovery. 

Treatment. — Congestion and accumulation of black blood in the 
large veins and large internal organs explain the coldness of the 
surface, and the effusion into the cellular membrane. 

Friction with warm flannel, and an emetic of ipecacuanha, to 
clear the air passages, should be tried; then give stimulants, such 
as warm white wine whey, ammonia, etc. 

Jaundice of Infants — Yellow Gum. 

Yellowness of the skin and whites of the eyes is very common 
with infants two or three days old; and this may depend on the 
active secretion of the bile, and of more being formed than is neces- 
sary. This will disappear without any medical treatment ; but 
when it does not go off in three or four days, we should give a tea- 
spoonful of castor-oil, and one grain of gray powder, with two or 
three of rhubarb. 

Purulent Ophthalmia of Infants. 

This disorder not unfrequently causes loss of sight, and often 
gives considerable anxiety to the medical man, until he is able to 
obtain a sight of the cornea (the central part of the eye) ; for the 
cornea may become opaque, or it may be destroyed by what is 
called sloughing (gangrene). The disease sets in on the second or 
third day after birth, and the white of the eye becomes red, the 
eyeUds swell, and matter rapidly forms ; but, very commonly, the 
first we see of the disease is two prominent bags of eyelids, which 
we can not separate, or if we can, severe pain is felt. Thus we 
can not see the cornea, which, moreover, always turns upward out 
of sight when the eyelids are opened. Light gives pain. 

The causes may be cold, or it may be that the eyes have been 
irritated during birth by certain acrid secretions or discharges in 
the passage of the mother. 

Treatment. — Some apply a leech or two, but we had better avoid 
doing so unless the inflammation is violent and the child strong. 

We should at once resort to astringents — 6 grains of alum to an 
ounce of rose-water, or three grains of sulphate of zinc to an ounce 



548 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

of rose-water. Some higlily praise dropping into the eye, three or 
four times a day, a solution of nitrate of silver (lunar caustic), con- 
sisting of ten grains to the ounce of distilled water. 

Every hour we should drop from a sponge, or throw in from a 
small glass syringe, some lukewarm water or chamomile tea; and 
without doing this, all else may be ineffectual. 

When the inflammation is severe, a cold poultice of bread and 
water, applied in a muslin bag, between the washing, etc., will help 
materially. Gentle aperients now and then. 

If specks remain on the cornea, they are often absorbed in 
course of time. 

Red Gum — Strophulus. 

^ Three or four days after birth, a few red pimples appear upon 
the face, neck, and hands, and there are diffused red patches inter- 
spersed. The redness varies in depth of color. No treatment is 
requisite ; and some nurses like to see the red gum ; it merely 
indicates a healthy state, and sensibility of the mucous membrane 
and of the integuments. 

The red gum sometimes attends dentition. 

Swelling of the Breasts of Infants 

is frequently to be met with, and need not be mentioned here, since 
no treatment is requisite, either local or general, were it not for 
the practice of nurses to set to and squeeze out all the milk, as 
they say. This they do until they have caused inflammation to be 
excited, which is often followed by an abscess, that is, the forma- 
tion of matter. 

The mother should not allow the child's breasts to be meddled 
with in any way ; the swelling will speedily subside. 

Whooping-cough,' or Partussis. 

This is a contagious disease, known by frequent fits of cough- 
ing, in which the breathing is broken, with great difficulty in draw- 
ing in the breath as well as expelling it. The inhalation is long, 
and produces, a sonorous or croaking sound. The disease may 
be divided into three stages. The first begins like a common 
cold, but a little more severe ; the second is the spasmodic stage ; 



WHOOPING-COUGH, OR PARTUSSIS. 549 

and the third the declming stage. The limits of these stages are 
not well defined, nor do they always show themselves, as the dis- 
ease sometimes runs its course without any perceptible change in 
this way. 

The whooping-cough generally begins like a common cold, with 
increased discharge from the nose, with redness of the eyes, and 
a watery discharge from them, accompanied by sneezing, irritation 
of the throat, a dry cough, and occasional fever. The observer 
will find that the cough nearly always comes on more in paroxysms 
than in common cold, and the face is more flushed. At the end 
of ten days, or two weeks, there is, generally, a decided change ; 
the paroxysms become more distinct, the whooping attends every 
spell of coughing, and the face is more flushed and swollen. These 
fits of coughing are not generally very regular in their periods, 
though sometimes they are quite so, and from occurring every 
hour, or even oftener, they gradually, as the disease advances, be- 
come less frequent, until they cease altogether. When they do 
become so unfrequent that there are but three or four spells dur- 
ing the twenty-four hours, the patient may, generally, be consid- 
ered safe. But these observations only apply to the disease in its 
regular course, which, indeed, is the one that is mostly found in 
practice. We, in fact, find that only a very few cases need medi- 
cation. Children run about without regard to weather, and gener- 
ally escape all difficulty. This, however, is not always the case, 
as we occasionally find stubborn cases which call for practice less 
or more energetic. 

When the whooping-cough occurs in damp or cold weather, or 
both at the same time, there is more danger than when the weather 
is warm or moderate in temperature ; for, in these latter condi- 
tions of weather, children do better than in the former. It is dur- 
ing the first two weeks of the disease that there is most danger, 
because, in this period, inflammation is more apt to occur. If the 
child be plethoric, and is predisposed to colds, it may, during this 
period, become seriously afi'ected by bronchial irritation, or even 
inflammation of the air-tubes, or it may have inflammation of the 
brain or its membranes, and be lost in this way ; but that which is 
most to be dreaded is congestion of the lungs, or inflation of them 
and the membrane surrounding them, which last is called pleurisy. 
These conditions of the lungs, and the pleura which surrounds 
them, is known by the very frequent breathing of the child, and 



550 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

moaning, with an effort to cry, every time the child strives to 
draw a deep breath. The skin, too, is dry, and the pulse too fast 
and too hard. The coughing, under these circumstances, gives 
great pain, and when the air-tubes are affected by inflammation, 
the disease is still more grave and painful. The face then be- 
comes, when the patient coughs, more deeply flushed, and more of 
a lived color. If these symptoms come on during the first stage, 
it may be considered that the second stage will also be of a grave 
character, and will need all the skill of the physician to carry it 
safely through to the concluding stage, and still have difficulties 
to contend with during that period. After the patient has gotten 
through the first four weeks of the disease, without any unfav- 
orable symptoms having occurred, it may be concluded that the 
worst is over, and that two weeks more will, in a great measure, ter- 
minate the disease, though it very often takes two months to effect 
a cure, and sometimes much longer ; for often, for months, the 
sufferer will have, on every accession of cold, a return of whoop- 
ing at each spell of coughing. Indeed, these severe returns some- 
times last for many months. 

The whooping-cough is a disease which is much more fatal in 
northern than in southern countries, and worse in damp climates 
than dry ones ; hence the great mortality in England, and espec- 
ially in London, when compared with the United States. There 
the mortality doubles that of this country in the same number of 
patients. 

It must be recollected that the whooping-cough is especially 
connected with early life ; but this is not always the case, for we 
occasionally meet with it among adults ; and this is particularly so 
in sparse populations, where children have but little opportunity 
of taking it. Within a few years, I attended a lady in confine- 
ment, who was thirty years of age, and who, within five minutes 
after the birth of the child, whooped severely, and continued to do 
so for several weeks. This lady had had a cough for some weeks 
before confinement. 

Treatment. — At the onset of this affection, but little is necessary; 
indeed, in a great majority of cases, no medicine is necessary fur- 
ther than that the bowels should be kept regular by a little rhubarb 
or castor-oil, that is, if they be costive ; and the child should wear 
flannel next the skin, and be protected!?' from severe cold, and from 
exposure to wet or rain. Should it take cold, and the breathing 



WHOOPING-COUGH, OR PARTUSSIS. 551 

be hurried, and attended with fever, an emetic should be directed 
of ipecacuanha. To a child two years of age, two grains of this 
medicine, in a little sweetened water, may be given every ten min- 
utes, until vomiting is brought on ; then a little warm drink may be 
given every twenty minutes, to promote the action of the medicine. 
Should this simple course not relieve the difficulty of breathing,'»it 
will then be proper to give a purgative of one grain of calomel and 
five of jalap, every two hours, until the bowels are freely opened. 
In the mean time, a warm bath, continued during a few minutes, 
will be useful. If now the child has lost the fever, and the cough has 
become easy, it may be allowed to return to its usual habits, but 
•without exposure. The nurse will find, by placing her ear to the 
chest, whether the breathing is natural or not, between each spell 
of coughing ; and when it is found not to be unnatural, there is no 
cause for alarm ; but, on the contrary, if there be quick breathing, 
with some rattling, when there is no cough, it will then be right to 
call a physician, and let him direct the proper course ; but if this 
be out of the question, then dissolve a grain of tartar emetic in 
two ounces of water, and give one tea-spoonful every four hours, 
as long as the patient can bear it, or until there is a mitigation of 
the symptoms ; then it must be discontinued. It is a good way to 
put the tartar into sixteen tea-spoonfuls of warm water, and give 
a dose with the same spoon, as often as directed. Very often half 
a tea-spoonful will be found as much as the patient can bear, and 
the quantity may be given at bedtime, with two drops of laudanum, 
or ten drops of paregoric, for several weeks, with great advantage. 
The dose must be made much less for very young children, and 
but seldom increased, until after the patient is more than six years 
old. In mild cases, it is, however, better to give the ipecacuanha, 
in emetic doses, once or twice a week, as this medicine never weak- 
ens the powers of the stomach. When the child is restless at 
night, there is no medicine so good as Dover's powders. A child 
two years old will bear two grains at bedtime, and, should it not 
have the desired effect in two or three hours, one more grain may 
be given. The efi'ect must be watched, so as to increase or lessen 
the dose, according to the impression made by the medicine. 

As the disease advances into the second stage, there is more 
of the spasmodic tendency than before, because, in this stage, we 
nearly always find the peculiar noise called whooping, and that 
condition which sometimes terminates in fainting and convulsions. 



552 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

To manage these cases, and this stage of the disease, it requires 
a different treatment from that of the first condition, where the 
whooping is little, and there is slight disposition to convulsive ac- 
tion. The same attention, must, however, be paid to the bowels and 
general system. It is in these two stages that the inflammatory 
tendency occurs, and it is with these that we have most to do, and 
in them the greatest danger lies. They are known, as has been 
stated, by fever-pain in the part affected. If in the brain, there is 
first pain in the head, intolerance of light, rolling the head on the 
pillow, and sleeplessness, and either contracted or dilated pupils ; 
the contraction first, and then the dilation. When the chest is the 
seat of the difficulty, the breathing gives pain, the cough is severe, 
but the whooping less ; and when the inflammation is fixed in the 
abdomen, there is tenderness in that part by pressure, and pain, 
with restlessness. Now, these symptoms must, in nearly every 
case, be combated by depletory measures. If the patient be stout, 
and advanced over two years, he should lose blood from the arm, 
which will mostly be of great advantage ; then his bowels must be 
moved with two or three grains of calomel, and as much Epsom 
salts as shall be necessary. One tea-spoonful, dissolved in water, 
may be given every hour or two, until it acts on the bowels. If 
the sufi"ering be confined to the chest, fomentations with hot water 
and flannel, or hop-water, should be kept on the chest steadily for 
some time. There should be calomel in one-grain doses, with 
Dover's powders, given every few hours ; and if there be little 
danger of weakening the stomach, the twentieth of a grain of tar- 
tar emetic, with the eighth of a grain of opium, or less, owing to 
the age of the child, should be preferred. Should the excitement 
not yield to the first loss of blood, leeches or cupping should be 
resorted to. Most of these inflammatory cases will yield to this 
treatment. When the brain is the seat of the irritation, cold water 
may be used on the scalp, or even ice, in a bladder, may be applied 
wdth safety : arid when the inflammation is thus located, leeches ap- 
plied to the temples will be of the greatest use. When the bowels 
are the seat of inflammation, calomel and opium must be used more 
fearlessly than when in the parts mentioned. But see the treat- 
ment of inflammations of these parts under the proper heads. 

We must always recollect that the whooping-cough, generally, 
is a disease that has a definite time to run, and that it can not be 
cut short by medication, unless, indeed, it outruns its usual length, 



WHOOPING-COUGH, OR PARTUSSIS. 553 

when we may have it in our power, by a proper course, to shorten 
its morbid continuance. These consequences, growing out of the 
debility produced by the severity of the disease, or the weakness 
of the constitution, have to be treated by those means that will 
regulate the bowels, soften the skin, mitigate the cough, act on 
the secretions of the liver and kidneys, and increase the general 
strength, and produce appetite. Now, to succeed in all these 
requirements, we must give the patient a warm bath once a day, 
clothe it with flannel, use gentle friction on the limbs, and expose 
the child to fresh air, even in winter, the last only for very short 
periods. ■ The sick chamber must be kept warm but well-venti- 
lated, and the patient must be allowed to exercise within doors 
as it wishes, and it will be found that a change of rooms will be 
beneficial in many cases. When the cough, in this latter state 
of the disease, is troublesome, Dover's powder at bedtime, gradu- 
ated to the age of the child, will be of great use. Should this not 
agree, a few drops of the tincture of hyoscyamus may be used, 
and often with benefit. From three to five drops can be given 
to a child two years old, in a little sugar and water, at bedtime, 
and repeated as occasion may require. Another excellent ano- 
dyne is paregoric and tincture of assafetida, in equal portions. 
The combination may be given at bedtime, or several times a day, 
in the amount of ten, twenty, or thirty drops. The paregoric alone 
is a good anodyne, and is especially so when combined with an 
equal amount of syrup of ipecacuanha ; twenty drops is about the 
quantity that should be taken at once. 

If, in the course of the disease, the patient should faint or be- 
come insensible at the close of a paroxysm of coughing, cold water 
should be sprinkled on the face, and, between the spells, the assa- 
fetida mixture should be given every two or four hours. A tea- 
spoonful will be the proper dose for a child three years old. This 
medicine can be given for some time, as there are no spirits in its 
composition. To bring about tone and appetite, tonics must be 
given, and those which will irritate the stomach the least should be 
preferred. Quinine, in half-grain doses, will be found among the 
best remedies for this purpose ; next, a watery infusion of the 
Peruvian bark, with sulphuric acid, will be found best of all the 
vegetable tonics. The way to prepare this last, is to put an ounce 
of coarsely -powdered Peruvian bark into a pint of cold water, and 
add one drachm of sulphuric acid. Let this stand 24 hours, and 



554 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

then strain through muslin, or filter through paper ; one tea-spoon- 
ful of this three times a day. The quinine can be given in powder 
or solution. It is sometimes proper to give the child iron; this 
may be done by giving one grain of the carbonate of iron in syrup, 
three times a day. Very large quantities do no more good than 
small ones. 

If the discharges from the bowels show a want of bile — that is, 
are light-colored — half a grain of calomel should be given every 
night until the color becomes brown. If there be costiveness, from 
two to five grains of rhubarb should be given with each dose of 
the calomel. But if there be diarrhea, then a grain of Dover's 
powder, with two of carbonate of soda, should be used instead of 
the rhubarb. This course must be persisted in until a change takes 
place. 



POISONING BY STRONG ACIDS. 555 



CHAPTER VII. 

POISONS, ACCIDENTS, FORMULARY, AND SPECIAL ADVICE TO 
EMIGRANTS. 

Poisonous substances, it is well known, are often used as reme- 
dies, and with great success ; the quantity constitutes the chief 
difference in many cases. 

Poisoning by Strong Acids. 

These acids are the sulphuric acid, or oil of vitriol, spirits of 
vitriol; the nitric acid, or aquafortis; the hydrochloric acid, or 
muriatic acid ; or spirits of salt, or muriatic acid. 

Symptoms or Effects. — A sharp, sour, burning taste in the mouth, 
and a burning in the gullet and throat and stomach ; bitter stuff 
is vomited with some blood ; at times, vomiting ; frequent stools, 
and blood passes with them ; pain in the bowels, like colic ; great 
thirst ; tenderness of the belly, cold clammy sweats ; attempts to 
make water frequent and painful ; breathing difficult ; restlessness, 
pale face ; convulsions and cramps ; mind remains unaffected. 
Death may ensue in a few hours, or in several days. 

Treatment. — Antidotes must be administered instantaneously, if 
possible ; much, if not all depends on time. Mix an ounce of mag- 
nesia in a pint of water, and give a wine-glassful instantly, and re- 
peat every three or four minutes. If no magnesia is at hand, put 
half an ounce of soap into, and dissolve it, in a pint of water ; ad- 
minister clysters of the same. Do not use the stomach-pump, on 
account of the inflamed throat, but give water, milk and water, 
barley-water, whey, gum arable mucilage very much diluted, or 
linseed tea. Then the inflammatory state is to be subdued by 
warm bath, fomentations, leeches ; no food so long as pain and 
inflammation in the stomach continues ; then food cautiously. 



556 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



Oxalic Acid, or Acid of Sugar. 

Symptoms not unlike those from the preceding acids. 

Treatment. — Give chalk and water, magnesia, or break down 
some mortar from the wall, and mix it into a paste with water. 
Then encourage vomiting, by tickling the throat and gullet ; or give 
an emetic — a tea-spoonful of flour of mustard in water, or two 
table-spoonfuls of common salt in water; but beware of giving 
much fluid until the acid has been neutralized by chalk, etc., which 
converts it into an insoluble matter, and prevents it from getting 
into the blood. 

^ PoisoNiNa BY Strong Alkalies. 

Fused potash; hydrate of potash, or commonly caustic potash; 
carbonate of potash, or salt of tartar ; oxide of sodium, or caustic 
soda; carbonate of soda, or kelp, or barilla, or washing soda; 
oxide of calcium, or lime, quicklime ; hydrate of lime, or slaked 
lime ; solution of lime, or lime-water. 

Symptoms. — A peculiar urinous taste in the mouth, acrid and 
burning, difliculty of swallowing, vomiting of matter mixed with 
blood ; the blood which is thrown up turns vegetable blue colors 
green. Then come on sharp pains at pit of stomach and in the 
belly, symptoms of inflammation in the bowels, hiccup, clammy 
sweats, purging of dark, bloody matter ; the mind wanders ; ex- 
haustion and death follow. 

Treatment. — Put three table-spoonfuls of vinegar or lemon-juice 
into three or four ounces of water, and repeat the draught ; or we 
may give freely of olive oil or almond oil, which would convert the 
alkalies into a soap ; or the sulphuric or muriatic acid might be 
given ; drop enough of either acid into a wine-glassful of water 
till it is as sour as weak vinegar. 

Then barley-water, mucilages, gruel, milk, whey, linseed tea, 
jellies ; then treat for inflammation by leeches, fomentations, etc., 
if necessary. 

Poisoning by Ammonia. 

Solution of ammonia, or volatile alkali ; sesquicarbonate of am- 
monia, or smelling salts, hartshorn, volatile salts ; hydrochlorate of 
ammonia, or sal ammoniac, baker's salt, and muriate of ammonia. 



POISONING BY ANTIMONY— IODINE POISON. 557 

Symptoms similar to those caused by potash, only more suffocat- 
ing ; convulsions and cramps are more frequent. When taken in 
small quantities, bleeding from the nose, mouth, or bowels may 
occur; the teeth drop out, and a fever like' hectic may prove 
fatal. 

When the vapor of ammonia is breathed too long, inflammation 
may ensue in the mouth, throat, and gullet, producing difficulty 
of swallowing, local pain, etc. 

Treatment. — When swallowed, give vinegar or lemon-juice, citric 
or tartaric acid, in water ; and give the remedy as soon as pos- 
sible, for death has followed in six minutes. When the vapor has 
been inhaled, the fumes of hot vinegar must be inhaled. For any 
consecutive inflammation, the usual remedies must be adopted. 
(See Chapter IV.) 

Poisoning by Antimony. 

Tartar emetic, James's powder, butter or muriate of antimony, 
Kermes' mineral, glass of antimony. 

Symptoms. — Metallic taste in mouth, from some of these ; vom- 
itings severe ; hiccough and heartburn ; pain in the stomach, with 
griping, purging, and fainting ; skin hot, sometimes deadly cold ; 
cramps, convulsions, giddiness, difficulty of breathing. 

Treatment. — Tlje decoction, tincture, or tepid infusion of galls 
are the antidotes ; a wine-glassful of the first and last, or a des- 
sert-spoonful of this tincture in water ; dilute freely ; then empty 
the stomach by the stomach-pump, and any one can introduce the 
tube of this pump, by passing it gently down the back of the 
mouth, gullet, and throat. After this, give decoction of yellow 
Peruvian bark ; check excessive vomiting with one grain of ex- 
tract of opium in sweetened water ; leeches, fomentations, etc., to 
pit of the stomach. 

Iodine Poison. 

Symptoms — similar to the foregoing, but the vomiting is not so 
excessive ; the pain at pit of the stomach is severe. 

Treatment. — Give mucilage of starch, arrowroot, or wheat flour 
in considerable quantity, until we may suppose the stomach nearly 
full ; then give an emetic of ipecacuanha ; and combat the inflam- 
matory symptoms by the usual means. 



558 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Arsenic as a Poison. 

White arsenic, oxide of arsenic, % powder ; Macquer's salt of 
arsenic, or arseniate of potash ; orpiment, or king's yellow ; Fow- 
ler's solution, or tasteless ague drop ; arsenical paste. 

Symptoms.—First, nausea and faintness come on ; then burning 
or hot pain in the stomach ; vomiting of greenish yellow matter, 
mixed with blood, after much retching, and increased by any thing 
taken into the stomach; swallowing difficult and painful; voice 
hoarse ; griping pains, with purging of green, watery-looking mat- 
ter ; bearing down stools ; belly drum-like and painful ; skin cold 
and clammy ; convulsions, palsy, and delirium. 

If the arsenic has been swallowed in lumps, death often ensues 
in six hours or thereabouts, with prostration, faintness, stupor, and 
convulsions ; and the vomiting and pain in the stomach are not 
severe. 

In some cases the patient may live five or six days, or even 
recover, though this last event rarely happens ; palsy or epilepsy, 
and locked jaw, with violent madness, sometimes occur. 

Treatment. — The stomach must be immediately emptied by the 
stomach-pump, and we must use lime-water instead of distilled 
water ; we must give drinks of tepid mucilages of sugar and water, 
chalk and water, and lime-water ; but we must avoid giving alka- 
lies. The best antidotes are charcoal, and the hydrated sesquiox- 
ide or tritoxide of iron. 

The arsenic causes inflammation of the stomach, which must be 
treated in the usual way ; and a diet consisting wholly of farina- 
ceous food must be adhered to, till all pain and uneasiness are 
gone. 

Poisoning by Mercury. 

Calomel, red precipitate, turbeth mineral, prussiate of mercury, 
Vermillion, corrosive sublimate. 

Symptoms. — A nasty metallic taste ; dryness of mouth and gul- 
let; vomiting, belching, hiccough; bloody stools; intense thirst; 
difficulty in breathing, swallowing, and making water ; cramps ; 
clammy skin; icy coldness of the skin and extremities ; convulsions, 
delirium, and death in from one to three days. 

Treatment. — Large quantities of white of egg — the whites of 
a dozen eggs, diluted in two pints of water — must be given re- 



COPPER AS A POISON— POISONING BY TIN. 559 

peatedly, till the stomach is full ; or else a mixture of soap and 
the gluten of wheat flour ; but if these are not at hand, Unseed 
tea, sugar and water, barley-water, or other soothing drinks, should 
be given. Then apply the stomach-pump, and treat whatever in- 
flammatory symptoms may arise. 

Copper as a Poison. 

Verdigris, or oxide of copper ; blue stone, blue vitriol, or cop- 
peras verditer. 

Symptoms. — Cooking in untinned copper vessels will cause this 
poisoning ; or cooking in vesS'els with copper stop-cocks, when any 
acid or grease is present. The tongue is dry and parched; an 
acrid coppery taste; coppery belching; spitting ; nausea, with often 
vomiting, or efi"orts to vomit; pain in the stomach, griping; purg- 
ing of bloody stools, with straining efi'orts ; belly painful and dis- 
tended ; heat of skin, with fever. These are followed by jaundice, 
weakness, faintness, difficult breathing, headache, scanty urine, 
cold sweats, cramps, and convulsions. 

Jaundice is never seen in cases of poisoning from arsenic and 
mercury. 

Treatment. — Dilute and mix the whites of a dozen eggs in two 
pints of cold water, and give wine-glassfuls every three or four 
minutes ; or give draughts of syrup, of sugar and water, till the 
stomach throws up its contents. Then administer the albumen in 
smaller doses than at first, and treat the inflammatory symptoms 
as usual. 

Poisoning by Tin. 

Butter of tin, salt of tin, muriate of tin, putty powder, flowers 
of tin, worm powder. 

Symptoms. — The salt of tin has been mistaken for common salt. 
Colic and purging. Taken in large doses, convulsions, palsy, and 
death are the efi"ects. 

Treatment. — Milk ; warm or cold water must be given often ; 
and magnesia should be mixed with the milk, or with albumen. 
For the colic, apply leeches and fomentations ; for convulsions, 
give opium, as recommended against convulsions in poisoning from 
antimony. 



560 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



Zinc Poisoning. 

White vitriol, white copperas, vitriol of zinc, flowers of zinc* 
Symptoms. — The usual taste of metal in the mouth, with tight- 
ness about the throat ; vomiting and purging, pains in stomach 
and belly, pale face and clammy skin, difficult breathing ; seldom 
death. 

T^'eatment. — Copious drinks of milk or warm milk and water; 
clysters, leeches, fomenting, etc. 

Silver as a Poison. 

Lunar caustic, fulminating silver. 

For symptoms, see those of mercury, though the stomach-pain 
is generally more severe, and the breathing is very laboring and 
heavy. 

Treatment. — Dissolve a table-spoonful of common salt in two 
pints of water, and give in glassfuls ; or else give sea water. Then 
an emetic had better be given, and finally inflammation must be 
subdued, if it arise. 

Poisoning by Niter. 

Nitrate of potash, saltpeter, salprunella. 

Saltpeter has been mistaken for Glauber's salts. 

Symptoms. — Vomiting of bloody matter, sinking pulse, clammy 
sweats, pains of stomach, faintness, convulsions. Death some- 
times in from three to sixty hours. 

Treatment. — No antidote is known, so we must give an emetic, 
or use the stomach-pump, with copious draughts of warm water, 
to promote vomiting. 

Poisoning by Liver of Sulphur. 

Hepar sulphuris, or sulphuret of .potassium, is used in medicated 
baths, and they are sometimes dangerous; but poisoning mostly 
ensues from taking it as a draught. Three or four drachms caused 
death in fifteen minutes. 

Symptoms. — Vomiting, faintness, pain, and sulphureted hydro- 
gen fumes may be smelt. 

Treatment. — Promote vomiting by a large tea-spoonful of mus- 



FORMS OF MEDICIXES. 561 



-• 



tard, or two table-spoonfuls of salt ; and give mucilaginous drinks, 
mixed with a weak solution of chloride (hypochlorite) of soda or 
lime, so long as the fumes of sulphureted hydrogen are smelt. 
After a time, clysters of the chlorides will be useful. 

Poisoning by Baryta. 

Heavy spar, ponderous earth, muriate of barytes, cawk, or 
heavy stone. 

Symptoms. — Vomiting, convulsions, palsy in the limbs, head- 
ache, deafness, pains in the belly, hiccup, colic. Death sometimes 
in eight or ten minutes, or within an hour. 

Treatment. — Give freely of the sulphates of magnesia or soda 
in water, and as soon as possible, for, in a little time, all may be 
lost. When the cawk, or heavy stone, which is a carbonate of 
barytes, has been taken, a mixture of vinegar with one of the al- 
kaline sulphates should be given. Sugared water, and mild sooth- 
ing drink afterward. 

Phosphorus. 

Symptoms. — From three-quarters of a grain to two grains, it 
has been stated, are sufficient to destroy life, and death may take 
place at various periods. The symptoms are those of inflamma- 
tion of the stomach and bowels. 

Treatment. — Give albuminous drinks, or some of the mucilages, 
having mixed magnesia with them ; then emetics and purgatives. 
But when once the symptoms have manifested themselves, it is dif- 
ficult to arrest their progress, for no antidote is known. 

Cantharides, or Spanish Fly, as Poison. 

Symptoms. — Vomiting or purging of bloody matter ; great pain 
at pit of stomach, with violent colic ; a quick pulse ; difficulty and 
pain in making water, and sometimes blood is passed. To the 
foregoing symptoms succeed convulsions, alternating with fainting ; 
delirium, and death. 

Treatment. — Drink freely of milk, thick linseed tea, or mucilage 
of gum arable. If there is no vomiting, give an emetic. 

Clysters of gruel, fomentations, and the hip bath should be made 
use of. 

36 



562 american household book of medicine. 

Swallowing Glass and Enamel. 

Make the person or child eat large quantities of beans, potatoes, 
cabbage, or bread, so as to fill the stomach and protect it from the 
edges or points of the glass. 

Lead Poison. 

Sugar of lead, white lead, litharge, Goulard's extract, red lead. 

Lead is often injurious to man, and is administered in various 
ways ; when taken in small quantities at a time, the disease called 
painters' or lead colic is produced (which see), but when in largely 
poisonous doses, the symptoms are metallic taste in the mouth, 
tightness of throat, pains in the stomach, retching, often of blood. 

Treatment. — Give freely of solutions of the sulphates of mag- 
nesia or of soda ; also milk or albumen in large quantity. The 
stomach-pump may be of service, or an emetic of sulphate of zinc, 
if there is no vomiting present already. 

Poisoning by Acrid Plants. 

These are aconite or monk's-hood, anemone, Barbadoes nut, 
bryony, buttercup, celandine, crown imperial, daffodil, elder, hedge 
hyssop, hellebore, marsh marigold, mezereon, meadow saffron, 
palma christi, poison vine or oak, savine, spurge, squills, staves- 
acre, virgin's bower, and wall-pepper. Besides these there are 
certain vegetable productions, which are poisonous ; these are acon- 
itine, colchicine, colocynth, croton oil, delphinine, elaterium, eu- 
phorbium, jalap, gamboge, oil of savin, scammony, veratrine. 

Symptoms. — Dryness and heat of the mouth, with a taste acrid 
or bitter ; there is a sensation of strangling in the throat, difficulty 
of swallowing, vomiting, purging ; pain, more or less, in the stom- 
ach and bowels. The nervous system then seems to suffer, and 
the person totters as if intoxicated ; the breathing becomes op- 
pressed ; great weakness and sinking, convulsions, and death. 

Treatment. — ^We must get rid of the poison, as soon as possible, 
by the stomach-pump ; or else by an emetic of twenty to twenty- 
four grains of sulphate of zinc, or by a tea-spoonful of flour of 
mustard, or two or three table-spoonfuls of common salt in water; 
or else tickle the back of the throat with finger or feather then 



l^ARCOTIC POISONS— POISONING BY PRUSSIC ACID 563 

encourage tlie vomiting by drinks of warm water, sugared water, 
barley-water, etc. Avoid giving vinegar or any acids. 

When stupefaction comes on, coffee; cold dash of water re- 
peatedly ; walking about, if feasible. 

Stupefying, or Narcotic Poisons. 

The poppy, bittersweet, yew leaves, cherry laurel, henbane, 
poison lettuce, prussic acid, opium, etc., come under this class. 

The symptoms are sleepiness, then stupor, palsy, apoplexy, and 
death. The pupils of the eyes are generally contracted. 

Treatment, — Here, again, we must get rid of the poison, by imme- 
diately introducing the stomach-pump, only using infusion of galls 
instead of water, if it can be quickly got; or we may give twenty- 
five to thirty grains of the sulphate of zinc in two table-spoonfuls 
of water, or by flour of mustard, or three table-spoonfuls of salt ; 
encourage the vomiting by irritating the gullet or back of the 
mouth. It is, however, often very difficult to excite vomiting in 
these cases ; then we should try this draught : 

No. 239. Carbonate of ammonia 20 grs. 

Powdered Ipecacuanha 30 grs. 

Tincture of capsicum 2 tea-spoonfuls. 

Water, or peppermint-water 3 ounces. 

When the stomach has been emptied, we must give frequent 
draughts of vinegar and water, or of some acid and water ; and 
brandy, coffee, with cordials, must all be given. Dashing of cold 
water over head and shoulders tends much to rouse ; and the per- 
son must be made to walk about as much as possible, whether 
they will or not. 

Poisoning by Prussic Acid 

is so rapid that little can be done to prevent death, which occurs 
very speedily. In one or two minutes the patient is usually quite in- 
sensible, the eyes fixed and glistening, the pupils dilated and unaf- 
fected by the light, the skin cold and clammy ; the limbs lie as if 
they had no stiffness or vitality in them, and the breathing be- 
comes slower and slower; the pulse can hardly be felt, and the 
stools and water, in some cases, pass away without any conscious- 
ness of the patient. Many have asserted that a shriek or scream 
is uttered as the last sound from the dying person ; but no such 



564 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

shriek or scream has been observed or heard in the human subject, 
though in some animals, as the cat, it is uttered. 

The symptoms caused by prussic-acid and by opium differ in 
several respects. In prussic-acid cases, the coma (stupor) is al- 
most instantaneous — in two minutes ; in opium poisoning it is sel- 
dom seeh for fifteen or twenty minutes. In this latter, the pupils 
are commonly contracted ; in prussic acid poisoning they are di- 
lated. Convulsions are more common in prussic acid poisoning ; 
in this latter, death occurs generally in less than an hour ; in that 
from opium, six to twelve hours is the average period of death. 

Treatment. — Apply "dilute ammonia, or smelling salts, to the nos- 
trils ; then give instantly some crystals of sulphate of iron, rubbed 
down in a mortar, with water ; give directly afterward some liquor 
of potash, a tea-spoonful in some water. The jaws are, however, 
sometimes so firmly set that nothing can be got into the stomach, 
unless by a Newington's tube, or a gutta percha one, to go round 
and at back of the teeth ; then we must dash buckets of cold 
water over the head and back repeatedly. Cold affusion, ammonia, 
brandy, and stimulants are what we must trust to. 

There is but little time for any thing to be done. 

Poisons, which ake both Acrid and STUPEFYma. 

This class comprises the deadly nightshade, hemlock, tobacco, 
poisonous fungi or mushrooms, ergot or spurred rye, camphor, 
strychnine from nux vomica, ardent spirits. 

Poisoning by Mushrooms. 

There is so great a difficulty in distinguishing the wholesome 
mushroom from the poisonous that they had better not be eaten, 
unless grown for the purpose in mushroom beds. The eatable 
kinds are the field or cultivated mushroom, the common morel, 
and the common truffle. We may suspect fungi, which grows in 
moist, shady places ; have many colors, or are gaudily colored ; 
are dirty or bitten on the surface, and have soft stems. The 
Russians eat them freely, but they always salt, boil, and compress 
them, and thus the mushrooms, perhaps, are rendered harmless, 
just as the pickling and washing of the poisonous agaric of the 
olive render it eatable by the natives of the Cevennes. In the 



NUX VOMICA— POISONING BY HEMLOCK. 565 

north-east of Asia, the Bug-agaric is eaten by the Kamtschadales, 
as an intoxicating agent ; and it causes the urine of those who 
have eaten it to possess an inebriating power, so that the urine is 
treasured up for that purpose. 

Symptoms are sometimes those of a narcotic (stupefying) kinji ; 
at others, of an irritant nature, giddiness, dim sight, with illusions 
of sight. After the drowsiness passes off, nausea and vomitino- 
succeed, though these states sometimes precede the stupor ; then 
come on pains in the bowels, convulsions. 

Treatment. — Use the stomach-pump ; and clear the stomach by 
emetics, by a tea-spoonful of flour of mustard, or three table- 
spoonfuls of common salt in half a pint of water. If inflamma- 
tion in stomach or bowels arise, leech ; and give purgatives, and 
treat as for inflammation. 



Nux Vomica, etc., as a Poison. 

Under this head come nux vomica, St. Ignatius's bean, false 
angustura, Indian nut or cocculus indicus, woorara or Indian arrow 
poison, camphire, strychnine, brucine. 

Symptoms. — Stiffness of back, head drawn back, irregular breath- 
ing, convulsions ; the breathing is by spasms or fits, until death 
ensues in one of them. The sixth of a grain of strychnine killed 
a dog in two minutes, and the third of a grain destroyed a wild 
boar in ten minutes. Brucine is twenty-four times less powerful. 

Treatment. — Empty the stomach by the stomach-pump, or by 
an emetic of twenty-six grains of sulphate of zinc, or mustard or 
common salt, as above ; then dilute freely with vinegar and water. 
If the breathing stops, try artificial respiration, as in cases of 
drowning. A spoonful of this mixture should be given every ten 
minutes : 

No. 240. Sulphuric ether 60 drops. 

Spirits of turpentine 2 drachms. 

Sugar -g- oz. 

Water 2 oz. 

Mix. 

PoisoNi^a BY Hemlock, Nightshade, etc. 

Deadly nightshade, water hemlock, fool's parsley, hemlock, hem- 
lock dropwort, tobacco, laurel rose, thorn-apple, rue, foxglove, 



566 AMERICAN HOUSEHOLD BOOK OF MEDICINE 

mancliineel, darnel or rye-grass, ergot of rje, atropine, nicotine, 
digitaline. 

Symptoms. — Agitation of a nervous kind; pain; convulsive 
movements of various parts; sometimes locked jaw; delirium, 
often of a very merry, laughing character ; retching, vomiting, 
and purging, with pains in the belly ; intoxication, with depres- 
sion and trembling ; a sinking pulse, clammy sweats, and death. 
The fool's parsley (oethusa cynapium) is common in gardens and 
hedge-rows, and it so much resembles the edible, innocent parsley, 
that mistakes are frequently occurring ; but it may be known 
from the garden parsley by the smell of its leaves when rubbed, 
which is peculiar, disagreeable, and very different from that pos- 
sessed by the leaves of parsley. The flowers are white; those 
of the garden parsley are of a pale-yellow color. 

The water parsnep or hemlock water-drop wort, is a very viru- 
lent poison ; it grows abundantly in the south of Ireland. The 
only way to distinguish it is, by the botanical characters. 

The true hemlock is the only plant of the kind with a smooth, 
spotted stem. The bruised leaves emit an odor like that of mice. 

Treatment. — An emetic of ipecacuanha and sulphate of zinc — 
twenty grains of ipecacuanha, with ten grains of the zinc or mus- 
tard flour, or common salt. The stomach-pump should be used, 
if at hand ; then give a purgative, Epsom salts or Glauber's salts. 
For the stupor, etc., do as is recommended for opium ; a little 
blood taken from the arm will relieve probably. If inflammation 
ensue, act accordingly. 

Poisoning by Alcohol — Akdent Spirits. 

Kum and brandy contain about fifty-three per cent, of alcohol 
by measure ; gin and whisky, about fifty-seven per cent. 

Symptoms. — Violent excitement, flushing of face, contracted pu- 
pils of the eyes, giddiness, and delirium, followed by dozing and 
dangerous sleep, and from this the patient may awaken only to die. 
The lividly-pale face, the deep snoring breathing, and a dilated, 
motionless pupil of the eye proclaim that death is not far off, or 
that recovery is beyond all hope. The breajh issues from the 
mouth, charged with the alcoholic vapor, by the smell of which 
cases of dangerous drunkenness may be discriminated from those 
of apoplexy ; the contracted pupil also distinguishes drunkenness 



PUTREFYING OR SEPTIC POISONS 567 

from apoplexy ; the pupils of the eyes are contracted in natural 
sleep, in poisoning from opium and alcohol ; it is dilated in com- 
pression of the brain. In Germany, Liebig tells us, a poisonous 
wine is drank ; that is to say, it is poisonous because fermentation 
is still going on; the heat of the stomach increases the effect of 
the carbonic acid gas which is given off from the fermenting wine, 
and this gas penetrates through the coats of the stomach, and rises 
through all the intervening textures, until it arrives at and fills the 
air-cells of the lungs, of course displacing the atmospheric air. 
The symptoms of suffocation from an irrespirable gas ensue. Here 
the best remedy is, to make the patient inhale the fumes of am- 
monia. This wine is called the feather-white wine. 

Besides this acute poisoning by alcohol, there are also cases of 
chronic or slow poisoning, infinitely more numerous, and quite as 
deadly in the long run, as those of acute poisoning. 

These chronic results of excessive drinking are cpJled delirium 
tremens. Irritative indigestion, fullness of the head, looseness of 
the bowels, vomiting, sometime jaundice, the nutmeg liver, dropsy, 
diabetes, palsy, insanity, are the symptoms and results. 

Treatment. — In all acute cases, empty the stomach by means of 
the stomach-pump, or by mustard, flour, or salt. Dash buckets 
of cold water over the drunken person, provided his skin is warm 
and not cold. Cold water into the ears has roused a little some- 
times. 

The carbonate and acetate of ammonia are the medicines to be 
given — ^three to five grains of the former in water ; heat to the pit 
of the stomach, loosening all tight cravats or ligatures about the 
neck, laying the head rather high; cloths dipped in warm vinegar, 
to rub the body with. The dangerous signs are a failing pulse, 
body getting colder, eyes insensible to light, labored breathing. 

Many are saved by the early occurrence of vomiting. 

With respect to delirium tremens, liver diseases, stomach and 
bowel ailments, jaundice, etc., see the respective articles for the 
proper treatment. 

Putrefying or Septic Poisons. 

Poisonous serpents and insects, mad dogs, diseased fish, sausa- 
ges, saveloys, etc., kept too long, rancid bacon, flesh of animals 
under certain circumstances. In 1842, some people in Toulouse 



568 AMERICAN HOUSEHOLD BOOK OF MEDICINE 

were poisoned by eating snails which had been feeding on the co- 
riaria myrtifolia. The mussel, oyster, crab, herring, trout, sprat, 
mackerel, salmon, and the eel come under this denomination. 

Symptoms. — Chills, pains in stomach and head, restlessness, 
thirst,, redness and swelling of face and eyehds, itching of skin, 
red, puffy blotches over the body, like violent nettlerash, convul- 
sions, and sometimes death in from three hours to as many days. 

Treatment. — This depends on the time which has elapsed since 
the poison has been eaten ; if within an hour, give an emetic — the 
mustard, common salt, or sulphate of zinc ; if a longer time have 
elapsed, give a strong purgative, to carry the poisonous materials 
quickly through the bowels. Give strong lemonade as a drink. 

Where a person has been bitten by any venomous snake, a sharp 
burning pain is felt where the two small wounds are visible ; swell- 
ing succeeds, to a great extent and degree ; red inflamed lines run 
up the limb, and knots of inflamed glands are visible in their course. 
Fever, with delirium, comes on ; anxiety and great depression, 
with weakness ; the breathing is labored, the pulse small ; pain at 
the chest-bone, fainting, thirst, a feeling of sickness, and vomiting. 
The wounded part becomes gangrenous, green-colored, and the 
part dies, and may be thrown ofi" in time, with an oifensive smell. 

Death from a viper's bite occurs in 30 or 40 hours usually ; but 
in the bites of the rattlesnake, the cobra di capello, etc., death 
occurs speedily ; unless the person survive the first deadly effect, 
then he is cut ofi* by irritative fever, inflammation, and the gan- 
grene. 

Treatment. — Apply a cupping-glass to the wounds ; then cut the 
skin with lancet or penknife, and apply the cupping-glass ; or suck 
with the mouth, which may be done with impunity, if the mouth 
and gums are every -where sound, and if the poison is spit out again 
directly. We should bind a ligature tightly around the limb, be- 
tween the bite and the heart. If the limb is swollen, the skin 
should be smeared with oil ; and if we see the wound shortly after 
it has been inflicted, a strong ascetic acid should be appHed to the 
wound, for this acid coagulates the poison. For the constitutional 
treatment, strong stimulants. Brandy and ammonia, and brandy 
has been given in very large quantities, without causing the slight- 
est intoxication ; it must be given in wine-glassfuls, very rapidly, 
and it will only just support the nervous system under the severe 
pinking produced by the deadly poison; besides, give 30 drops of 



PUTREFYIXG, OH SCEPTIC POISONS. 569 

the compound tincture of ammonia, in water, every half hour. In 
the island of St. Lucia, where bites from the deadly coluber carina- 
tus are frequent. Dr. Ireland cured all his cases of bites from this 
snake by giving arsenic — two drachms of Fowler's solution of ar- 
senic, ten drops of laudanum, and half an ounce of lime-juice every 
half hour ; six to eight doses sufficed usually. If this solution is 
not at hand, half a grain of arsenic may be given every half hour. 
The success of the Tanjore pill suggested the use of arsenic. 

There is strong evidence as to the good effects of poultices of 
ipecacuanha in the bites of venomous snakes. We read of the 
guaco, the ophyoxyllon, and of other plants being successful reme- 
dies, both as preventives of danger and as curatives ; but the best 
plan to be adopted is the one detailed above. 

The fever and local inflammation, with its gangrene, must be 
treated on general principles. (See Inflammation.) Painting the 
swollen, inflamed part with tincture of iodine — thirty-four grains 
of iodine to each ounce of spirits of wine — will do the most good 
in the early stage. It should be applied by a brush every day, 
and the swelling and inflammation sometimes are speedily reduced. 

When gangrene has set in, and the parts are separating, with a 
bad smell, the charcoal poultice, often renewed ; put cloths, wetted 
with solutions of chloride of soda or lime, over the parts. 

A great deal of bile is formed in snake-bites ; so, where the sink- 
ing and exhaustion are gone by, an emetic would be advisable, if 
there had been no vomiting previously. For much pain, give opium, 
thirty drops or more of tincture of opium, at night, or oftener, in 
some water. 

In the Indies, in Africa, and South America, much irritation and 
suffering take place from the stings of insects. The scorpion's 
bite produces a sharp pain, local inflammation, with depression and 
some constitutional suffering, which, in one case, lasted thirty-six 
hours; but Kirby and Spence tell us that the black scorpion of 
Ceylon frequently inflicts a mortal wound. ,^ 

The scolopendra is sometimes a foot long in Jamaica and else- 
where ; and some spiders in hot climates can inflict tolerably severe 
wounds. The tarantula of southern Italy has been the subject of 
many fabulous accounts ; its bite produces no injurious effects on 
the human subject. But a spider is found in the East (the argas 
persicus, the punaise venimeuse de miana of travelers) whose bite 
is poisonous, causing low fever; but this account has been denied 



570 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

bv several travelers, as well as affirmed; it is not likely that so 
small an insect should produce such alarming effects in a human 
body by a single bite. 

The bee, the wasp, the hornet, musquito, and the harvest-bug 
often cause great irritation, in proportion to the number of stings. 
The most fatal cases, and the only fatal cases from a single sting, 
is where a wasp or bee has been swallowed in some fruit, and then 
stung the back part of the throat, or near the windpipe. 

Treatment. — In the case of a sting in the throat, apply leeches 
externally, and use gargles of hot salt and water, to cause a flow 
of saliva and mucus, "and so lessen the swelling ; but if suffocation 
be threatened, open the windpipe. This can be done with a com- 
mon penknife, or very sharp knife, if a person will but insert the 
point and shoulder of the knife in the exact central line of the fore- 
part of the throat, about seven-eighths of an inch to one inch be- 
low the projection called Adam's-apple. Of course, if a medical 
man can be obtained, he should be waited for ; but if there is no 
one, and suffocation threatens life, it is better for a non-professional 
person to do it, if he possess coolness and courage. 

The central line is the spot, and the instant the air-pipe is opened, 
the operator will be made aware of it, by a rush of air, and by all 
resistance to the knife's point ceasing. 

In stings from bees, wasps, etc., examine the part with a lens, 
and extract the stings, which are often left in the wounds, with a 
pair of forceps or small pliers. Apply cold water. Some recom- 
mend scraped flour, chalk, or starch ; some apply oil. 

The author paints with tincture of iodine, once every day or 
every other day ; but Goulard water is very useful, keeping the 
part always wet with renewed wet linen. 

Hydrophobia. (See Chapter lY and Index.) 



ACCIDENTS. 



Suspended animation, or asphyxia, is of frequent occurrence. 

The atmosphere is continually receiving quantities of freshly 
evolved gases, from various sources, but Nature has set up various 
modes of keeping the air pure. 



APPARENT DEATH FROM CHARCOAL VAPOR, ETC. 571 

From a curious statistical digest, not long ago publislied, it ap- 
pears that the human family numbers 700,000,000, and its annual 
loss is 18,000,000, which produces 624,400 tons of animal matter, 
which, in turn, generate, by decomposition, 9,000,000,000 cubic 
feet of gases, which are cleared away from the atmosphere* by 
vegetable matter decomposing and assimilating them for their own 
uses. But let these gases be evolved into, and retained within, 
confined or narrow bounds, they will render that place very dan- 
gerous for human beings to live in, particularly to sleep in. 

Apparent Death from Charcoal Yapor and Carbonic Acid 

Gas. 

We hear of deaths from persons sleeping near lime-kilns, or in 
close rooms, where charcoal or coke has been burning. In pits, 
wells, and in breweries, where fermentation is going on, there is 
danger from this gas ; also, in very crowded rooms, where many 
candles or lamps have been burning,, and many grown-up persons 
vitiating the air. 

One per cent, of carbonic acid gas in a room will cause uneasi- 
ness, and ten per cent, is probably the limit where immediate dan- 
ger to life is threatened ; and every grown-up person vitiates 216 
cubic feet per hour of the atmospheric air. And, thus, if too 
many persons sleep in a room, or pass several hours crowded to- 
gether in rooms which are not properly ventilated, the atmosphere 
becomes dangerously deteriorated, and many are carried out half 
fainting, or headache comes on, etc. 

Cool air, admitted into a crowded apartment from the floor, has 
its temperature raised from ten to twenty degrees by the time it 
rises to the height of the heads of the people in the room. At 
this altitude it receives the admixture of carbonic acid gas from 
the mouths and nostrils of those who are in the room ; and the 
air is further vitiated by the burning of candles, and the exhala- 
tions from the skins of so many people. 

The air ascends and accumulates above, but it is displaced by 
successive portions of heated air, cools, and redescends below the 
faces of the persons, to be again breathed, until it can be^breathed 
no longer, from its increasing impurity. If the room is well ven- 
tilated, and the vitiated, heated air is carried oif as fast as it is 
formed, no mischief of this kind can ensue. 



572 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Animation is sometimes suspended, by people, on going to sleep, 
leaving a fire burning in the sleeping-room, which fire is useful so 
long as it burns; but when, toward morning, it goes out, the cold 
air descends the chimney, and drives fumes of carbonic acid gas, 
sulphur, etc., into the bed-room. In the holds of ships there is 
often an accumulation of this gas. 

Whenever this is feared, we should try the purity of the air by 
letting down a lighted candle, which burns with an elongated flame, 
if the air is a little vitiated, but goes out at once if there is much 
of this gas ; but there still may be danger, even although the can- 
dle continues to burn, so we must not depend on that alone. 

If any one falls into this gas in wells, or ships' holds, or else- 
where, let no one try to extricate him rashly; he should wear over 
the mouth and nostrils a cloth soaked in lime-water, or in a weak 
solution of caustic potash, or even in plain water. Water should 
be dashed over the person and place, or the gas let out (if in a 
large beer-barrel), by making a hole instantly with an axe, at it3 
bottom, when the gas will pour out like water, being much heavier 
than the atmospheric air. 

In all rooms where this gas may be expected to accumulate, one 
mode of ventilation may be derived from the chemical action of 
lime, and we should spread a quantity of newly-slaked lime on a 
. board ; the lime, by its affinity for it, will absorb the carbonic acid 
gas from the atmosphere of the room, and thus purify it, giving 
admission to fresh, pure air. 

To show the baneful eff'ects of this gas upon the health of people, 
Dr. Chadwick relates that typhus fever occurred frequently, and 
fifty-seven cases of it in two months, in a large tenement house, 
wherein numbers of poor people lived crowded together. At 
length, the doctor induced some one to fix into the ceiling of each 
room a tube, which communicated with the chimney of a neighbor- 
ing factory. From that time fever was well-nigh expelled from 
the place, since ventilation had been efi'ected. 

Symptoms. — Death, from drowning, or strangulation, arises from 
a negation of air, but from carbonic acid gas there is a poisonous, 
narcotic (stupefying) action also ; the symptoms vary with the 
proportion of the gas inspired. 

In fatal cases, the person is rendered instantly insensible, and 
he falls to the ground, or lowest point; the breathing is at first 
difficult and snoring, but it soon ceases altogether ; the body con- 



COAL GAS, CARBURETED HYDROGEN, ETC. 573 

tinues warm, and the limbs are flexible, though sometimes stiff or 
convulsed ; the face is of a leaden color, or very pale, particularly 
the lips and eyelids. Vomiting occurs in some. 

On recovery, headache, pain or soreness in the body, and some- 
times palsy of the muscles of the face occurs. 

Treatment. — Pouring cold water over the body should be prac- 
ticed, and the chest and extremities and soles of feet rubbed with 
stimulating liquids and a brush ; if the body is cold, a warm bath. 
When signs of recovery are apparent, blood should be taken from 
the arm, if feasible. Blowing into the air-pipes, not too strongly, 
with a pair of bellows, may be useful. Smelling salts to the nos- 
trils. When roused, give some brandy ; rub the body dry, and put 
him into a warm bed. 

In suspended animation from charcoal vapor, from coal vapor 
or sulphurous acid, the vapor of lime-kilns, or from confined air, 
the treatment is similar. 

Coal Gas. — Carbureted Hydrogen. — Carbonic Oxide. 

The odor of this gas is well known, which is owing to the vapor 
of naphtha ; and we must be cautious wherever it is to be smelt, 
for it may do much mischief, although considerably diluted. This 
odor is sensible when the gas forms only a thousandth part ; it is 
more so when forming a seven hundredth, and it is well marked 
when forming an hundredth and fiftieth part. When air contains 
nine per cent, of it, it may destroy life, if long respired. Beware 
of taking a lighted candle into any place where this gas is sus- 
pected to be. It is a very penetrating gas, passing through floors, 
bricks, etc. 

Symptoms. — Nausea, headache, vomiting, weakness ; mind is con- 
fused; some paralytic symptoms may exist; pale face, impeded 
breathing, and other signs, such as are before described, or con- 
vulsions. 

Above nine per cent, of this gas forms an explosive mixture with 
air. 

Gas from Drains and Sewers. — Sulphureted HYDRoaEN. 

From six to eight per cent, of this gas might kill. 
Symptoms. — Giddiness, sickness, debility ; face pale, lips of vio- 
let hue, and the person falls inanimate. If the gas is less con- 



574 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

centrated, the symptoms vary, acting like a narcotic irritant, 
whereas it is a narcotic when concentrated. 

Treatment. — Removal into pure air, pouring of cold water over 
the body, bleeding, stimulants. This gas will destroy life by its 
action on the skin ; for a rabbit, which was inclosed in a bladder 
of sulphureted hydrogen gas, but which was allowed to breathe 
freely in the atmosphere, died in ten minutes. 

Apparent Death from Drowning. 

A person can not remain beneath the surface of the water longer 
than two minutes without a suspension of animation taking place. 
Among the Navarino sponge-divers, not one of them could sustain 
the entire submersion of the body for two consecutive minutes; 
and the average period was seventy-six seconds ; and the best 
pearl divers of Ceylon could rarely sustain immersion longer than 
fifty seconds. 

How long the period of entire submersion is required to be for 
death to take place, when there is no longer a hope of resuscita- 
tion, is not settled ; for while some, who had not been entirely sub- 
merged for longer than a minute, and whose bodies were still warm 
and pliant, could not be resuscitated, others have been recovered 
who had been submerged several minutes; yet equally judicious 
treatment may have been adopted in both cases. 

The probable reason is to be found in the fact that the suscepti- 
bihty to the restoration of life may be different in different individ- 
uals ; and while some are more tenacious of life than others, and 
more easily acted upon by stimuli, the circumstances preceding or 
attending the submersion may also differ. 

Resuscitation has been effected after an entire submersion of 
five consecutive minutes, and, perhaps, this might be taken as a 
maximum ; still, many instances are on record of recovery after a 
submersion for a much longer time. Some of these narratives are 
entitled to credit, though others are altogether to be discredited. 
Our duty is plain enough, and that is, to persevere in our efforts 
to restore animation for longer than the above statements would 
encourage us to do. In one case, an hour and a half elapsed be- 
fore there were any signs of returning animation ; and in Dr. 
Douglas's case, resuscitation began to be established, though feebly, 
even then, after eight hours and a half spent in treatment. 



APPARENT DEATH FROM DROWNING. 575 

Treatment. — Immediate treatment is of the utmost consequence; 
a delay of ten or more minutes, or less, may be fatal ; and it is 
more important to look to this than to the mere period of sub- 
mersion. Wipe the body dry ; raise the head and shoulders ; re- 
store the warmth of the body by warm blankets, bottles of Jiot 
water, bags of hot sand, applied especially to the pit of the stom- 
ach and to the feet ; the warm water bath or warm air bath. The 
hot air bath is preferable to the water bath, because the skin then 
acts as a respiratory organ ; the heat of the bath should be 98° or 
100°, supposing the submersed person to have been taken out of 
water of from 50° to 60° of temperature ; or the bath may be as 
tot as the hand can bear ; but if submersed in water but little above 
82°, the heat of the bath should not exceed 85° or 90°; for the 
temperature of an animal is in proportion to the quantity of air 
it consumes, and a sudden rise of temperature, demanding a con- 
sumption of more oxygen, might be fatal instead of useful. 

We should apply stimulants (ammonia) to the nostrils. We 
should clear the mouth and nostrils of mucus, and try to move 
the chest mechanically, by pressing on the chest-bone or ribs, and 
allowing them to rise again; and, above all, we must diligently 
rub all parts with stimulating applications, the compound camphor 
liniment, or tincture of cantharides and oil, etc. 

Some try artificial inflation of the lungs by the bellows ; but 
Mr. Woolley, of the Humane Society, denies its efficacy, while it 
interferes with our keeping up energetic friction. More good 
might ensue from getting air out of the lungs than by forcing any 
in, because the mechanical movement of the chest in respiration 
might follow. If the bellows inflation is tried, our efi'orts should 
be gentle, or the air-cells may be ruptured. 

Electricity or galvanism has been recommended; and though no 
time should be lost in waiting for either, yet, when ready, either 
should be tried. Galvanism might be of service, one disk being 
placed at the back of the neck, the other at the pit of the stomach 
in front, and the galvanic influence so passed. 

As soon as signs of recovery appear, and a power of swallowing 
has returned, we may administer stimulants — brandy and water, 
wine, etc. Some throw into the stomach a little of one of these 
stimulants, by means of a stomach-pump. 



676 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



Suspended Animation from Steangling or Hanging. 

Symptoms. — The venous blood is prevented returning from the 
head by the rope round the neck ; thus the face becomes nearly 
of a black color, the eye-balls stand out from their sockets, and 
the nostrils are unnaturally widely distended. 

Treatment.— Bleed from the jugular vein or arm directly, use 
the bellows to inflate the lungs, and treat as for drowning, with the 
exception of restoring warmth to the body by artificial warmth. 

Substances falling into the Air- pipe. 

When this is the case, if the body is not readily dislodged, and 
distress increases, cut into the air-pipe, in the central line, an inch, 
or a little less, below the projection in the neck, called Adam's- 
apple, with a good penknife. This may be done without danger. 

Substances in the gullet may often be shot out by an effort at 
vomiting, or dislodged by some one putting his forefinger down as 
low as he can, or by a pair of small pliers. 

Lightning Stroke. 

Little is to be done ; galvanism might be tried, and the bellows, to 
inflate the lungs. "A fever often follows recovery from this accident. 

Intense Cold 

Symptoms. — General numbness ; a sort of intoxication ; incli- 
nation, almost irresistible, to sleep ; loss of consciousness, of sen- 
sibility, and of life. 

Treatment. — Wrap the body in a blanket ; rub the naked body 
with snow, pounded ice, or cold water, rubbing from the body to- 
ward the legs ; then, after some time, rub with cloths dipped in 
milk-warm water, so as to restore , warmth gradually. If no snow 
or ice be at hand, cold-water bath, and rubbing while in the bath. 
When the skin begins to feel warm, put into bed, and treat as for 
drowning. 

Frost-bitten parts must be treated on similar principles, by rub- 
bing them with snow, pounded ice, or cold water; and we must be 
very cautious in giving stimulants, or applying external heat, in 
however slight a degree. 



APPARENT DEATH IN NEW-BORN INFANTS. 577 



Apparent Death in New-born Infants. 

This occurs with two sets of symptoms — one where the skin 
is pale and bloodless. Here the navel-string must not be cut, 
twisted, nor dragged ; but we should raise the infant's head, wr^p 
the body in flannel, use hand-friction to the back -bone and the 
soles of the feet, while the head and face should be exposed to 
the air ; and we must try artificial breathing through any small 
tube or pipe. 

If the skin be dark and discolored, and the face swollen and 
livid, or dark-colored, the navel-string must be cut and allowed to 
bleed ; while the head is to be held up, and the chest and belly 
are rubbed with w^arm flannels. If no blood will flow, we must 
apply one or two leeches behind the ears, and put the infant into 
a warm bath. Artificial breathing should also be tried. 

Substances in the Eyes. 

If sand, or any small substance, or an insect, etc., get into 
the eye, it may best be removed by means of a camel-hair pencil 
dipped in oil, or by a bit of paper rolled up into the form of and 
size of a quill, and softened in the mouth. When the substance 
gets fixed in the coats of the eye, it may be removed by the thumb- 
nail, or by a blunt-pointed piece of wood. 

Insects and Substances in the Ears. 

Insects may be killed by dropping in any sort of oil, as the oil 
of almonds, or olive oil. Small substances may be extracted with 
small forceps, pliers, or tweezers ; and they should be extracted 
as soon as possible ; for, if inflammation were set up, it might, in 
some constitutions, cause danger, by extending to the brain. 

Leeches may be expelled from any place by a strong solution 
of common salt. 

Burns and Scalds 

have been treated of in the fourth chapter (see Index) ; but here 
we may say, that for trifling and non-extensive burns and scalds, 
cold water or Goulard water may be applied, and renewed as soon 
as they become warm. The blisters are not to be opened for two 
37 



578 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

or three days ; then with a needle. Cerate or carron oil may be 
applied ; an aperient, and poultices afterward. 

In children and infants, even slight burns are dangerous. For 
severe burns or scalds, or where they are extensive, no cold ap- 
plications, but bathe the parts with linen dipped in warm spirit of 
turpentine, or spirits of wine ; then a cerate of one part of oil of 
turpentine and two parts of Bp^silica ointment, or of common lard, 
if no other cerate be at hand. Open all blisters with a needle ; 
if there is much discharge, sprinkle finely-powdered chalk, and 
apply a linseed poultice over the parts. » 

A low fever often follows. Do not lower by bleeding or by 
strong purgatives, but support the strength, not by stimulants, but 
by rice-milk, chicken broth, and such like. 

When matter (discharge) begins to form, dress with creosote 
ointment — thirty drops of creosote to one ounce of lard ; rub them 
well together. This may prevent scars from being so deep as they 
otherwise might be. 

Sprains 

are sometimes very severe accidents, producing great pain and 
swelling, followed by inflammation; and where a large joint, such 
as the knee, or even the ankle, is affected, there may be fever also. 
Treatment. — Rest in the position the most easy for the part is 
essential ; neither should the sprained part hang down ; fomentations 
of hot water, or cold water, if the sufferer find more ease from it 
than from hot. The inflammation must be first completely sub- 
dued ; and if it linger about, two or three blisters, to remove it. 
Then rub the part, two or three times a day, with the hand, or 
with opodeldoc ; after some time, moderate exercise, and a flannel 
bandage, evenly applied. Sprains often leave a weakness of the 
part behind, if they are not properly treated at first. 



Bruises, or Contusions, 

may be of all degrees of severity, the pain and swelling correspond- 
ing. Sometimes the swelling is so great that the skin threatena 
to burst; then a small opening should be made. The skin is dis- 
colored, turning from a reddish hue to a black, and in no long 
time. In about three or four days the color is violet, and the 
edges fade away into the surrounding skin ; the color becomes, in 



CUTS AND WOUNDS. 579 

a few more days, green and then yellow, when the discoloration 
soon after disappears. 

Treatment. — In slight cases, we must bathe the part with vine- 
gar and Yfater, or spirits and water, or paint them with iodine 
tincture, twenty grains to the ounce of spirits of wine, if any 
iodine be at hand. The bruised part should, like the sprained, be 
kept at rest, and in a raised position. Cold or iced water is a 
good application ; but in the severer cases, inflammation must be 
guarded against by leeches near to the part, not on it ; by purga- 
tives, low diet, and rest. 

Cuts and Wounds. 

A simple cut, of no great depth nor extent, merely requires to 
have its edges brought together by sticking plaster, after the part 
has been thoroughly cleaned from dirt, etc. ; but sometimes an ar- 
tery is wounded, and the case becomes serious. When cuts bleed 
much, we shall know when an artery is wounded, by the blood 
issuing forth in jets or jumps ; if it flows evenly out, and is not 
of a bright red color, the blood comes from a vein. In all cases, 
pressure is necessary ; and when an artery is wounded, put your 
finger at once and boldly into the wound, down to the bleeding 
point or spot, which spot is ascertained by the warm, gushing 
blood. Keep your finger there, until other arrangements can be 
made. Apply a tourniquet on the limb, above the wound, or a 
silk handkerchief twisted tight by a piece of wood. The pressure, 
to be efi"ectual, must be nicely applied ; and the first application 
should be of lint or linen, formed into a fine point, which should 
fit accurately the bleeding point; upon this lay another piece of 
folded linen, a little larger ; over that another, until there ^re sev- 
eral, and all must be kept tightly pressing on the point by a band- 
age, to keep all in their places. Rest, of course, is essential. 
But if a large artery be wounded, a surgeon becomes necessary, 
to stop the bleeding, by putting some silk thread round the vessel 
higher up on the limb. 

Fractures, or Broken Bones. 

These should be put under a surgeon's care as soon as possible ; 
but if no one is at hand, an attempt must be made to do what is 
necessary. The symptoms of fracture are evident — loss of mo- 



580 AMERICAN HOUSEHOLD ^OOK OF MEDICINE. 

tion, with distortion or deformity of the limb, which may be bent, 
shortened, or twisted ; the ends of the fractured bone grate on 
each other on moving them, and there will be pain on motion, and 
spasms or startings of the muscles. 

Treatment. — Remove the person in the gentlest manner possi- 
ble ; and then the ends of the broken bone are to be placed in 
their natural position, so maintained, and perfect rest must be af- 
terward enforced. 

To effect the first purpose, the broken ends often ride over each 
other; then the limb requires to be extended, that is, pulled 
gently and firmly in the proper direction, and so fixed that the 
muscles may not again displace the broken ends. Before doing 
this, we must relax all the muscles which oppose our efforts, as 
far as we can, and keep the limb in as easy a position as possible. 
This is called setting or reducing the fracture, and requires two 
persons, one to hold firm one part of the limb, the other to extend 
or pull it downward, or in the right direction. 

The limb must next be maintained in this position by some me- 
chanical contrivance. For this purpose splints are used ; they are 
made of thin plates of wood. A measure should be taken of the 
sound limb, and the splints should be made long enough to rest 
against the firm, projecting bony points of the limb. The splints 
should be scored in their length, so as to allow of their readily 
adapting themselves to the part ; and wherever they rest upon or 
touch projecting points, a padding of loose tow, or thick blanket, 
must be inserted. These splints are kept in their places by band- 
ages ; but if there is much swelling, the splints and bandages must 
not be applied till it is gone down ; and if swelling come on after 
their application, they must be taken off, or inflammation and gan- 
grene may ensue. Wherefore, every one should examine daily the 
state of the limb, after the bandages have been applied, to detect 
the first and earliest appearance of swelling. 

Other splints have been tried — pasteboard softened in boiling 
water, so fitted to the part, and allowed to dry and stiffen ; or lay- 
ers of lint and bandage, or old linen, soaked in starch mucilage, 
forms a dry, light, yet unyielding support. Straw splints may be 
used, made by filling a linen bag of the size required with un- 
broken wheat straw, such as is used in thatching, the straw being 
cut to the length of the limb, and the open end of the bag then 
sewed up. 



DISLOCATIONS. 581 

If muscular twitches of the limb are troublesome, some tincture 
of opium must be given, twenty-five or thirty drops at night, in 
water. Inflammation must be subdued by cold lotions, aperients, 
leeches, etc.; and if debility come on, the strength must be sup- 
ported, without stimulating. 

Broken bones become consolidated in young persons from the 
twenty-eighth to the thirtieth day after the accident ; in grown- 
up people from the thirtieth to the thirty-fifth day; and in the 
aged, from the thirty-fifth to the fortieth day. 

If a fracture has united crookedly, an attempt must be made to 
set it right, by bending the part ; and this can be usually done 
with success before the fourth week has elapsed, and even later. 

Dislocations 

may happen at any time, and should be reduced immediately, be- 
fore the person has recovered from the shock, and before the mus- 
cles have had sufficient time to contract and fix the bone in its 
new position. 

Dislocations are distinguished from fractures without difficulty ; 
there is none of the grating noise usual in fractures ; the fractured 
bone, when set right, becomes distorted again directly, not so the 
dislocated bone. The fractured bone is more readily moved than 
even the sound bone, not so the dislocated bone ; the form of the 
joint is changed in this latter. 

Treatment. — A toAvel, applied so as not to injure the skin, is to 
be fixed round the dislocate,d bone, while another is to be wrapped 
round the body, or applied to the upper limb, so as to afi'ord a 
fixed and unyielding point of resistance. Then the dislocated bone 
must "be gradually extended (pulled upon), until the head of the 
dislocated bone is on a level with the joint, when the muscles of 
the part, aided by a little guiding of the operator's hand, will cause 
the bone to occupy its natural situation. 

Bandage the limb, so as to prevent its free use for a few days ; 
and pumping cold water may tend to strengthen the joint. 

All this should be done at once, and can be, by any cool, coura- 
geous person ; for, if much time go by, and the dislocation remain, 
pulleys are often required to efi'ect the reduction, and tartar emetic 
to lower the power of the resisting muscles, in which case a sur- 
geon's help is indispensable. 



582 AMERICAN HOUSEHOLD BOOK OJF MEDICINE. 



Ruptures 

are soft swellings which appear in the groins, generally very sud- 
denly, and after straining, or some violent muscular effort. 

If the fingers be placed on the swelling, an impulse may b© felt 
by them, on the person coughing. Now, the danger from this 
swelling is, that from costiveness, or other causes, it may enlarge, 
become hard, suffer pressure at its narrowest part, inflame, and 
put life in immediate danger, and require nothing less than a 
surgical operation. 

When any one is thus afflicted, let him or her lie down, and, 
after a time, the swelling will probably reenter the abdomen or 
belly, whence its contents were propelled. If not, after a few 
hours' rest in the horizontal position, the swelling may be pushed 
up into the abdomen by the fingers of the patient. 

The next point is to keep the said contents in their proper place, 
and this can only be done by stopping the hole of exit with a truss ; 
and a truss, single or double, as the case may require, should be 
applied over the part where the swelling commenced, and worn 
constantly, while at work or in the erect position. Every one neg- 
lecting this precaution is always in danger. 

Trusses should fit so well as to give no pain by their pressure 
anywhere. 

The only other necessary precautions are to keep the bowels 
always gently open, so that a hard, straining motion is never nec- 
essary. For this purpose, the powder for piles, of sulphur and 
jalap, is useful (see Piles), or two or three tea-spoonfuls of Epsom 
salts, with ten grains of powdered jalap, and as much of powdered 
ginger, when necessary, never allowing the stool to become hard. 

Avoid riding on horseback as much as possible, and all great 
or sudden muscular efforts. 

Fainting Fits. 

Keep the head low, give cold water, and sprinkle a few drops 
over the face. Some wine or brandy, or sal volatile, thirty drops 
in a wine-glassful of water. 

Convulsive Fits. (See Convulsions ; also Epilepsy and 
Apoplexy, and Hysteria, or Hysterical Fits.) 



FORMS OF MEDICINES. 583 



FORMS OF MEDICINES 



Lotions 



are applied to cool the affected parts ; then they should be renewed 
as soon as tliey become warm. If they are meant to soothe or act 
like a fomentation, then put a piece of oiled silk over the linenj 
wetted with the lotion. 

Iced water is a good lotion to inflamed parts, and when the head 
is hot ; also in delirium, etc. A cap of ice, or ice in water, in a 
bladder, or in a Mackintosh cushion, are all of use. 

In summer, water may be cooled down to the freezing point by 
either of the following mixtures : 

Sal ammoniac, 5 parts ; niter, 5 parts ; water, 16 parts. Or, 
nitrate of ammonia, 1 part ; carbonate of soda, 1 part ; water, 1 
part. Put the water into a vessel, and the vessel into the freez- 
ing mixture, and put flannel around the vessel which contains the 
freezing mixture, 

Nitro-Mwiatie Acid Lotion. — Of nitric acid, J oz. ; muriatic 
acid, 1 oz. Mix. Half an ounce to a quart of water, for a lotion 
to the right side, when there is deficient action of the liver; to be 
applied by linen laid on. Two ounces of this acid to a gallon of 
water for a foot bath in similar cases, and in costiveness. 

Spirit Lotion, — Of spirits of wine, 1 oz. ; of water, 15 oz. Mix. 
Apply by means of a piece of thin muslin, to allow of rapid evapo- 
ration. 

Goulard Water. — Of sugar of lead, 14 grains ; of vinegar, 1 or 
2 tea-spoonfuls ; of spirits of wine, 1 tea-spoonful, and of soft 
water, 8 oz. 

The spirits of wine may be omitted. This lotion should not be 
applied over open skin — over open ulcers, etc. 

Zine Lotion. — Of sulphate of zinc, 60 grains ; of soft water, a 
pint, for bruises, and as an injection against the whites. 

Alum Lotion — is made in a similar way, and used in similar 
cases — in sore mouth and gums, and against the whites. 

Drops or Lotion for the Eye. — To 1 oz. of soft water add from 
2 to 4 grains of sulphate of zinc, or 1 grain of sulphate of copper, 
or 1 grain of nitrate of silver. Either of these is useful in in- 
flamed eyes. Drop one or two drops night and morning; but 



584 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

leeches to temples should precede, unless the inflammation is scrof- 
ulous. (See Ophthalmia.) 

Liniments 

are to redden the skin, and should be rubbed in ; they tend to 
remove swellings which are connected with local debility. Dip a 
rag in ether, or camphorated spirit, and la}^ it upon the skin, cover 
over with oiled silk — in colds, sore throats, etc. ; or do so with 

Liniment of Ammonia^ or Oil of Hartshorn.- — Of liquor of am- 
monia, 1 oz. ; olive oil, 2 oz. Mix, Or, of carbonate of ammonia, 
J oz. to 1 oz. of water ; then add the oil. 

Opodeldoc- — Soap Liniment.— Oi hard soap, 1 oz. ; of camphor, 
120 grains ; spirits of wine or of rosemary, 5 oz. Mix. To this 
1 oz. of tincture of opium may be added when the object is to 
allay local pain; rub it only on sound skin. 

Turpentine Liniment.— -Oi soap, 1 J oz. ; camphor, J- oz. ; spirits 
of turpentine, 8 oz. Mix. This is for severe burns. 

Liniment of Lime Water. — Of linseed oil and of lime water, 
equal parts. Mix. For burns. 

Liniment to bring out Yellow-headed Pimples. — Of olive oil, IJ 
oz. ; of tartar emetic, 2 drachms. Rub two tea-spoonfuls into the 
part, night and morning, until pimples begin to appear. These 
pimples leave no scars behind them ; those produced by tartar 
emetic ointment often do. 

Ointments. 

Tartar Emetic Ointment.- — Of tartar emetic, 60 grains ; lard, 1 oz. 
Mix. This is used like the preceding— to reheve pain, internal 
chronic inflammation, etc. 

Ointment for Piles. — Of powdered galls, 60 grains ; lard, 1 oz. ; 
of strong solution of subacetate of lead, 15 drops. Mix. 

Ointment for the Eyelids. — Of citrine ointment, 80 grains ; lard, 
I" oz. Dissolve with gentle heat. 

Sulp>hur, or Itch Ointment.— Of^ sublimed sulphur, IJ oz. ; lard, 
4 oz. ; rub well together. If we add 1 oz. of subcarbonate of pot- 
ash, it will be more eflicacious ; or J of an ounce of sal ammoniac 
will answer equally w^ell. 

Spermaceti Ointment. — Of spermaceti, f of an oz., or 6 drachms ; 
white wax, 2 drachms ; olive oil, 3 oz. Mix with gentle heat. 



SINAPISMS— CROTON OIL —BLISTERS. 585 



Sinapism, or Mustard Poultice. 

These redden the skin. Mix equal parts of flour of mustard 
and of linseed meal. If the flour of mustard be made of the yellow 
mustard, mix the two together by means of hot vinegar ; if it-be 
made of the brown mustard, mix with hot water only. Make into 
a paste, and spread it on a rag, and apply. The brown mustard 
contains the husks as well as the seeds, and the acrid oil in them, 
of which oil the vinegar will destroy the efficacy. Let it remain 
on some eight or ten minutes, or so long as the pain or stinging 
is not very sharp ; but in cases where these poultices are applied 
to a person who is unconscious, we must not allow the mustard 
plaster to remain longer than an hour, or gangrene might ensue. 
If redness, without pain, is wanted, mix with the paste a drachm 
or 60 drops of tincture of opium, or double that quantity of tinc- 
ture of henbane. These diminish the pain, but do not impair the 
efficient action of the mustard. 

Croton Oil 

is often applied in deep-seated pain or disease ; one part of this 
oil to five parts of olive oil. Rub the skin first with a piece of 
flannel, dipped in vinegar of the strong kind, till the skin reddens ; 
then rub in the oil, and repeat every six hours, till some small 
points of eruption or pimples appear ; cease then to rub ; the pim- 
ples fill with liquid, dry, and the scarfskin scales ofl". 

If these yellow-headed pimples, which are made to appear by 
rubbing in croton oil, tartar emetic ointment, or solution, give much 
trouble, or cause too much irritation, warm bread and water poul- 
tices, or of linseed meal, will soon remove it. 

These applications should be made in the morning, so that the 
night's rest may not be broken in upon. 

Blisters. 

Blistering plaster should be always kept on hand, ready for 
spreading, as it is prepared in the shops. This plaster is to be 
spread over a piece of leather, or even brown paper, to the thick- 
ness of a dime ; then wash the part to be blistered with soap and 
water, rub dry with a rough towel, apply the plaster, and keep it 



586 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

on the part by strips of sticking plaster, but so as to press but 
slightly on the blister, otherwise the blister will not rise. 
• If the patient is afflicted with difficulty or irritation in passing 
his urine, or has a tendency so to suffer, or even if he be of an 
irritable habit, the blister had better be taken off in about six hours 
after it has been applied ; or an edge or corner may be lifted up, 
and if the skin begins to redden, or is become red, take it off. The 
blister will still rise, and no strangury is probable. And it is as 
well to cover the blistering plaster with gauze or some silver paper, 
moistened with oil, and so apply it. This is better than having to 
drink so very freely of barley-water, etc. ; still, these drinks must 
be taken, if there is any pain or difficulty in passing the water. 

It should be applied on going to bed ; it will not prevent sleep, 
and by the morning the work is done. 

If people are very sensitive, or are afraid of the pain, mix five 
or six grains of extract of henbane with the plaster. 

An imrnediate Mister may be made by applying steam to the 
part, but this may be dangerous ; another w^ay is to heat a piece 
of polished metal, tolerably thick, so as to retain the heat some 
minutes, in boiling water, and apply it to the part affected. Also 
by nitric acid. 

Blister by Lunar Caustic. — Mark the outline of the proposed 
blister wdth ink on the skin, then moisten the bottom of the stick 
of caustic, and pencil over the part, across and in all directions, 
till the part is covered. It leaves a black stain on drying, and mat- 
ter forms under the outer skin. No dressing is required, but merely 
making a small hole at the lowermost point of the blister. 

In dressing a common blister, let out the fluid by a small open- 
ing ; but do not cut off the raised skin unless we w^ant to keep up 
an open or perpetual blister. Dress with spermaceti ointment, 
spread on the soft side of the lint, and it will soon heal, probably. 
To keep the blistered surface open, it is often dressed with savin 
cerate ; but many can not bear the irritation. In applying this 
cerate, we must always, at every dressing, remove the film that 
forms over the blistered surface; otherwise the part dries and heals. 
To remove this film, we must apply a hot poultice for four or six 
hours, or a hot fomentation, to loosen the film, which can then be 
removed. 

In some habits, after some diseases, which have left this skin 
weak, and in many children, blisters will often not only refuse to 



POULTICES. 587 

heal readily, but they are followed by gangrene, and here we must 
poultice with charcoal or yeast poultice, give ammonia and bark, 
support the strength, etc. (See Gangrene, Chapter lY.) This 
teaches us to be cautious with respect to blistering young children, 
or applying blisters in severe cases of measles, scarlet fev^r or 
other skin diseases, or where even great general debility is mani- 
fest. 

Poultices 

enable us to apply moisture and heat, and are applicable where 
fomentations are usually required. They should not be heavy, 
nor yet very bulky ; but the great point to be attended to is their 
frequent renewal. Poultices are necessary when an inflamed part 
throbs and forms matter (discharge) ; then the sooner the matter 
is brought to a head, as it is called, the better, and the warmth and 
moisture of poultices promote suppuration. After the matter has 
burst forth, or the part been opened, a few more poultices should 
be applied, to clear the part completely. 

But there are swellings to which poultices must not be applied; 
they are called aneurisms, and each aneurism consists in a per^ 
manent dilatation of an artery, sometimes produced by external 
violence, at others by debility or some disease in the coats of an 
artery. 

The symptoms are, a swelling in the course of an artery, which 
beats like the pulse, or, as it is phrased, pulsates ; and, on placing 
the ear to the SAvelling, a puffing noise may often be heard. 

It might readily be imagined easy to distinguish a swelling of 
this nature from any common swelling, but often it is very difficult 
to do so, and even experienced surgeons have been deceived ; and 
non-professional persons might easily endanger hfe, by first poul- 
ticing, and then using the lancet, or something else, to open the 
swelling. A gland, or any hard swelhng, when situated over the 
course of an artery, seems to pulsate, being raised at every pulsa- 
tion of the blood-vessel beneath it ; here aneurism is supposed to 
exist when it does not. 

The rule of safety is, never to meddle with any swellings which 
beat or pulsate, like the vessel at the wrist, called the pulse. Do 
not poultice, nor apply any thing ; but merely protect from press- 
ure or from a blow ; maintain rest and quietness, and consult a 
surgeon as soon as convenient. 

•' 



588 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Bread and Water Poultice. — Pour boiling water over a thick 
slice of bread, having previously removed the crust. Soften with- 
out pressure, by stirring it about ; then drain, and spread it on a 
rag, as hot as possible, and apply. If the poultice do not require 
very frequent changing, we should add some lard, to keep it moist 
and prevent lumps. 

Oatmeal Poultice. — Keep some water boiling in a pan, and add 
oatmeal gradually, and in small quantities, until the poultice is 
thick enough. Lard may be added to this, as to the one before. 

Arrowroot Poultice. — Mix two or more table-spoonfuls of arrow- 
root with cold water, till it is all united; then add boiling water 
enough, until a .thick, jelly-like paste is made. This is an excel- 
lent application, and very soothing for irritable, tender sores. 

Alum Poultice. — Mix sixty grains of alum with the whites of 
two eggs, till they form one body. This is useful for black eyes 
from bruises. 

Charcoal Poultice. — This consists of two ounces of bread, an 
ounce and a quarter of linseed meal, powdered charcoal three 
drachms, and ten ounces of boiling water. 

The bread stands near the fire in the water for some time ; mix 
it, and add the linseed by degrees. When well mixed, add and 
mix in two drachms of the charcoal, and sprinkle the other drachm 
over the surface. Or any common poultice may be made, and 
charcoal added. 

This is useful in gangrene, and in stinking sores, or ill-smelling 
discharges, as where pieces of bone are coming away from a leg. 

Yeast Poultice. — Of beer yeast and water, heated to one hun- 
dred degrees, of each five ounces, or some say, eight ounces ; flour, 
a pound. Mix the yeast with the water, and add gradually the 
flour, stirring assiduously. Place it near the fire until it rises. 

Useful in cases similar to the preceding, of foul, fetid, irritable 
ulcers. 

Hemlock Poultice. — Of extract of hemlock half an ounce, boil- 
ing water half a pint; add linseed meal enough to make a poultice. 
For irritable painful sores. 

Linseed Meal Poultice. — Of boiling water ten ounces, powdered 
linseed four and half ounces, or more if necessary. Add the Un- 
seed to the water, stirring constantly. 

A good poultice, but should be often renewed. Some deem it 
more irritating to the skin than the bread and water or arrowroot 



FOMENTATIONS. 689 

poultice. The husk of the linseed contains oil, and this adapts 
it for poultices. 

Carrot Poultice. — Bruise boiled carrots into a pulp, and apply 
it — to foul, irritable ulcers. 

Cataplasm of Chlorinated Soda. — Of boiling water, six oun&es ; 
powdered linseed, four and a half ounces ; solution of chlorinated 
soda, two ounces ; stirring constantly ; add the linseed gradually 
to the water, then add the soda. Applied to foul ulcers, to cor- 
rect foul discharges. 

Mustard Poultice. — Of tepid (not boiling) water, ten ounces ; 
powdered linseed and mustard, of each two and a half ounces, or 
what may be necessary. Mix the powders well, and add them 
gradually to the water, stirring well. 

Boiling water would lessen the acrimony of the mustard, so it 
should be only tepid, this poultice acting by its irritating quah- 
ties rather than by its heat. 

It should be applied to soles of the feet in low or typhus fever, 
when delirium or stupor is present, in apoplexy and diseases of 
the head, and in deep-seated inflammatory pains. 

It should be spread on cloths, to the thickness of half an inch, 
and left on the part until redness is excited, but it should not be 
left on so long as to cause blistering. It is an excellent applica- 
tion where a speedy effect is required. 

The Onion Poultice. — This is made like the carrot poultice. 
It is highly stimulant, and well" adapted to bring forward indolent 
swellings, etc. 

A lump of figs is the most ancient poultice on record. (See 
2d book of Kings, chap, xx., ver. 7.) 

Fomentations. 

Like poultices, apply heat and moisture ; the best consists of 
flannel cloths, wrung out of boiling water by two sticks turned 
in opposite directions. Shake them up, and lay these flannels 
lightly over the part, and the heat is retained a long time. Two 
pieces of flannel should be kept in readiness, each about two and 
a half or three yards long, with the ends sewed together to admit 
of the boiling water being wrung out of them ; the coarser the 
flannel the better, as it retains the heat better, and white flannel 
is preferable to colored. 



590 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Fomentations with poppy heads are liked by some persons ; 
but the heat and moisture are the chief, if not sole agents. It 
may be wise sometimes to employ them; they may act through 
the mind. 

Stupes. 

It is sometimes of benefit to stupe a part, as in eye disease. 
The patient should operate for himself, by putting a piece of 
flannel in the hollow of his hand; wring it out of boiling water 
first, and then let sixty drops, or a tea-spoonfiil of tincture of 
opium, or of henbane, or of hemlock, be poured on the flannel, 
and held at a proper distance, so that the vapor can be safely 
received, and allowed to rise to the eye or part afi'ected. 

Fomentations and stupes are the means of applying warm vapor 
and liquids, but there is a powerful aid toward the prevention of 
disease, and the strengthening of weakly, delicate habits, in the 
application of cold water sponging. The chest should be sponged 
night and morning, back and front. Parents often object, on the 
ground that their children are too dehcate, etc., but if we add a 
little spirit to the water, they become reconciled to the application. 
A bracing and tonic influence .is thus exerted over the nerves ; 
and disease may be kept off, or will be better borne when it has 
attacked. 

An alcoholic lotion, consisting of one part of spirits of wine 
and five parts of water, has been strongly recommended as a suc- 
cessful preventive of consumption. It is applied by means of six 
folds of linen, three inches broad, which are tightly stretched over 
the upper part of the chest, and over which one fold of flannel 
should be put. 

Both this lotion and cold sponging should be tried in all cases 
of debility and of delicacy of habit. 

Frictions with the naked hand, or with embrocations, or with 
the flesh-brush or gloves, are useful in indolent glands or swell- 
ings. The strokes should be brisk, with the tips of the fingers, 
and 120 in a minute. A little hair powder or flour will prevent 
the skin from suffering. In or after a bath they are useful; and 
in cases of deep-seated pains, friction with a liniment composed of 
equal parts of oil of turpentine and tincture of opium, will often 
give temporary relief, or ten grains of opium powdered, rubbed 
in a mortar with one ounce and a quarter of olive oil. A dessert- 



MEDICINES, ANTACIDS, AND THEIR DOSES. 591 

spoonful of either should be poured into the palm of the hand, 
and used each time. 

Slow, gentle, and equal friction will often bring on sleep ; and 
it is useful to know this fact; children may often thus be put to 
sleep. Shampooing and percussion are good substitutes for exer- 
cise when persons are confined to their beds or couches. 

Medicines, Antacids, and their Doses. 



Liquor of potash 10 drops to 30 well diluted. 

Carbonate of potash 10 grains to 30. 

Carbonate of soda 30 grains to 60. 

Subcarbonate of ammonia 5 grains to 10. 

Sal volatile 30 drops to 60. 

Chalk prepared 30 grains to 120. 

Magnesia 30 grains to 60. 

Carbonate of magnesia 60 grains to 1 ounce. 

Hard soap or Spanish soap .... 5 grains to 30. 



'Chalk Mixture against Diarrhea. 

Prepared chalk -i- oz. 

Sugar ^ oz. 

Gum arable J oz. 

Water 1 pint. 

Rub the gum arable into powder ; add the chalk, then the sugar; 
lastly, add the water by small quantities, in a mortar, rubbing all 
the while until an emulsion is formed. Tincture of opium, or of 
catechu, or of kino, may be added in obstinate cases. The opium 
for bearing-down stools especially, fifteen to twenty drops of tinc- 
ture of opium for a dose. Of the other tinctures, thirty drops for 
a dose. 

Gregory's Powder consists of 

Powdered rhubarb J- oz. 

Calcined magnesia 1 oz. 

Ginger (powdered) J- oz. 

Rub well together, and keep in a well-stoppered bottle, in a dry 
place. 

The Poor Man's Mixture for Stomach Pains and Acid with Wind. 

Rhubarb 60 grs. 

Calcined magnesia 90 grs. 

Ginger (powdered) 20 grs. 



592 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Mix, and add one pint of peppermint water; and of tincture 
of capsicum, tincture of opium, and of spirits of sulphuric ether, 
each sixty drops ; a table-spoonful two or three times a day. 

These medicines act chemically, by neutralizing the acid in the 
stomach and bowels • they are palliatives, removing the effects of 
disease only. 

Worm Medicines 

are of three kinds — those which remove the slime of worms me- 
chanically and by a purgative action ; those which strengthen the 
bowels, and so prevent the formation of slime; and those which 
kill the worms, as turpentine. 

D0SE8. 

Calomel 5 to 10 grs. 

Black sulphuret of mercury 5 to 30 grs. 

Iron filings 2 to 60 grs. 

Carbonate of iron 2 to 240 grs. 

Tin filings 60 to 240 grs. 

Tansy leaves 30 to 60 grs. 

Cabbage-tree bark 20 to 40 grs. 

Assafetida : 10 to 30 grs. 

Scammony 5 to 10 grs. 

Kue . , 10 to 60 grs. 

Spirits of turpentine 10 drops to 1 oz 

Olive oil i oz. to 8 oz. 

Cowhage 5 to 10 grs. 

Wormwood 20 to 60 grs. 

Carolina pink 10 to 40 grs. 

Male fern-root 60 to 240 grs. 

Gramboge 3 to 20 grs. 

aarlic 60 to 120 grs. 

Camphor 2 to 20 grs. 

Sagapenum . , . , 10 to 30 grs. 



Aperients, 

or laxatives, act by unloading the bowels of offensive matter, with- 
out exerting any considerable effect on the vessels of the bowels, 
or on the secretions of the liver, etc. They would seem merely to 
stimulate the muscular fibers of the bowels, and so cause a quick 
expulsion of their contents. 



CATHARTICS. 593 

DOSES. 

Manna i oz. to 2 oz. 

Casia pulp i oz. to 1| oz. 

Charcoal in fetid belchings 10 to 20 grs. 

Magnesia 30 to 60 grs. 

Carbonate of magnesia 30 to 120 grs. 

Sulpliur 30 to 120 grs. 

Castor oil and seeds J oz. to 1 oz. 

Tamarinds 1 dr. to 1 oz. 

Dandelion root and herb 30 to 60 grs. 

Hard soap 5 to 30 grs. 

Carbonate of soda 10 to 30 grs. 

Tartarized soda 60 grs. to 1 oz. 

' Cream of tartar 60 grs. to 1 oz . 

Croton oil J drop to 2 drops, 

which may be dropped on the tongue. 



Cathartics. 

Some act mildly, others more sharply; some lower the pulse, 
and give rise to a feeling of cold; such are saline purges, best 
adapted for fevers ; others are more tonic, as aloes, rhubarb, etc. ; 
others are stimulant. Purgatives cause irritation, and lead to the 
formation of indigestion, by causing the secretion of hastily-formed, 
and, therefore, imperfect bile, if they are too frequently taken. 
Exposure to cold air should be avoided when a purgative has been 
taken. When saline cathartics and castor-oil are given, demulcent 
liquids should be drank warm; but if Epsom salts be given, give 
it in a small quantity of water, and in an hour afterward a basin 
of weak tea or warm gruel should be taken, which Avill carry down 
the bile flowing out of the gall ducts, which have been stimulated 
by the salts. 

When pills have been given, diluents should not be taken till 
after the first evacuation. 

Cathartic Pills. — Of compound extract of colocynth, 10 grains. 
Make into 2 pills. To be taken on going to bed ; next morning, 
a seidlitz powder, or a table-spoonful of Epsom salts, wich some 
powdered ginger, or a few drops of essence of ginger. 

Croton Oil Pills. — Of croton oil, 1 drop ; crumb of bread enough 
to make a pill ; or, in apoplexy, 1 or 2 drops may be dropped 
on the tongue when the power of swallowing is lost. 
38 



594 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Compound Cathartic Pills. — Of jalap, powdered, and calomel, 
eacli 45 grains; gamboge, 10 grains. Mix well; add extract of 
colocynth, compound, 60 grains. Make this into five-grain pills. 
Excellent for torpid liver. One pill acts mildly, three very act- 
ively. 

Mercurial Cathartic Pills. — Of compound extract of colocynth, 
4 grains ; of calomel, 1 to 2 grains ; of blue pill, 3 grs. Make 
up two pills, to be taken at bedtime. Useful when the liver is 
torpid and bowels sluggish ; the motions clayey. 

Blue Pill. — Five grains of this, at night, for a few nights ; or 
alternate nights, and a quickening draught in the morning, in bil- 
ious disorders. 

Pills of Aloes and Myrrh. — Of socotrine aloes, J- ounce ; of 
saffron and of myrrh, each 2 drachms. Make into pills, weigh- 
ing 5 grains each. For females who have irregular or deficient 
periods, or have sluggish lower bowels. 

Pills of Aloes with Ginger. — Of aloes, J ounce ; powdered gin- 
ger, 1 drachm ; hard soap, J ounce ; oil of peppermint, 30 drops. 
Make into five-grain pills. A warm stomachic purgative, or ex- 
tract of gentian may be added. 

Aloes and soap, in equal parts, with syrup, if necessary, is a 
good form. 

Compound Rhuharh Pills. — Of rhubarb, '^ ounce ; of aloes, 2t 
drachms ; of myrrh, J- ounce ; oil of peppermint, 30 drops. Beat 
into a mass with syrup of orange-peel, and make into five-grain 
pills. Two for a dose. 

Gamboge Pills. — Of Gamboge, aloes, and compound cinnamon 
powder, each 60 grains ; soap, J ounce. Make into a mass, and 
into five-grain pills. These are for obstinate costiveness. 

Powdered jalap may be added with good effect. 

Elaterium Pills. — Of elaterium, 1 grain ; extract of colocynth, 
20 grains. Make six pills. This often acts violently. Given in 
cases of dropsy. 

A Black Draught. — Of Epsom salts, J- ounce ; compound infu- 
sion of senna, IJ ounce; compound tincture of cardamoms, 60 
drops. Mix. To be taken in the morning. 

A more active Draught. — Add to this 1 drachm of tincture of 
jalap. 

Cordial Aperient Tincture, — Of tincture of senna, seven parts ; 
of wine of aloes, one part. Mix. A table- spoonful of this, at 



EMETICS. 595 

bedtime, acts well next morning, usually, and is fitted for gouty 
and cold habits. 

Not so well adapted where there are piles. 

Aperient for those afflicted with Piles. — Of sulphur, of powdered 
jalap, and of cream of tartar, each, J ounce ; of compound cin-* 
namon powder, 2 drachms ; niter, 1 drachm. Mix. A tea-spoon- 
ful, or two or three, in water, whenever necessary. Or this : Of 
sulphur and of tartarized soda, each, J ounce. To make four 
doses; one night and morning, till a gentle action ensues. 

A pleasant Aperient. — Of carbonate of magnesia, 5 drachms ; 
of distilled water, 16 ounces. Dissolve 1 ounce of citric acid in 
4 ounces of distilled water; add 2 ounces of syrup of lemons. Then 
mix the two together, in a strong bottle, such as is fit for holding 
champagne ; cork over, and tie over as well. Keep the bottle in 
cold water, or in the cold, till wanted. A fourth or sixth part for 
a dose, every four or six hours, till a proper action ensues. This 
may be called a champagne aperient. . 

Manna and Epsom Salts. — Of Epsom salts, 1 ounce ; manna, 
J ounce ; compound infusion of senna, 7J ounces ; tincture of car- 
damoms, J ounce. Mix, by rubbing the manna gradually into the 
infusion. Two or three table-spoonfuls for a dose. 

Baume de Vie, or Compound Decoction of Aloes. — Of liquorice 
root, |- ounce ; subcarbonate of potash, 40 grains ; aloes, myrrh, 
and safi"ron, each 60 grains; water, 1 pint. Boil to 12 ounces, and 
strain ; when cold, add 4 ounces of tincture of cardamoms. 

Dose, a wine-glassful once a day, in the morning, or when nec- 
essary. 

A useful Aperient. — Of jalap root, 1 to 2 drachms ; of com- 
pound infusion of orange-peel, 6 oz. Let it stand for a few hours. 
Two table-spoonfuls for a dose. Epsom salts might be added, if 
desired. • 

Infusion of senna. — Of senna leaves, 15 drachms ; of ginger, 
bruised, 80 grains ; boiling water, 1 pint. Let it stand in a cov- 
ered vessel for an hour or two ; then strain. The ginger corrects 
the griping quality of the senna. 

Compound infusion of Senna.— Of^ tamarinds, 1 oz ; of senna 
leaves, 1 drachm ; coriander seeds, bruised, 30 grains ; sugar, J oz.; 
boiling Avater, 8 oz. Let it stand on the hob, in a covered vessel 
not glazed with lead, for 4 hours ; then strain. 

Mild Aperient. — Of tartarized potash, 1 to 2 drachms ; com- 



596 AMERICAN HOUSEHOLD BOOK OP MEDICINE. 

pound infusion of senna, 1 oz. ; tincture of cardamoms, 1 draclim. 
To be taken at bedtime, or early before breakfast. 

Emetics. 

Emetics evacuate the contents of the stomach, but they do a 
great deal more ; they promote sweating in fevers ; they favor 
expectoration in disorders of the lungs ; they promote absorption 
of the fluid in cases of dropsy, and they help, by the commotion 
they excite in the body, to remove obstructions in the interior of 
the body, as in jaundice and in torpor of the liver ; they also favor 
the return of the periods ; they allay the spasms in asthma, and 
check discharges of blood from either the lungs or womb, but they 
are best given, for this latter purpose, in small doses, so as to ex- 
cite a feeling of sickness, and not vomiting. In dysentery, also, 
emetics have been useful. 

But they should not be given when there is internal inflamma- 
tion ; in fullness of the head and its vessels ; in advanced stages 
of pregnancy ; in persons ruptured, nor sufi*ering from prolapse 
of the womb ; nor in persons who have weak and delicate stomachs. 

The early evening is the best time to give emetics, if a choice 
be left; for sleep will be grateful after the action of vomiting is 
over. The person should walk about, if he can, until the vomiting 
comes on, and then he may drink of tepid water to encourage the 
vomiting, and render it easy ; but too much water must not be 
drank, or the stomach will be over-distended. 



Ipecacuanha 10 to 30 grs. 

Sulphate of copper J to 5 grs. 

Sulphate of zinc 10 to 30 grs. 

Tartarized antimony J to 3 grs. 

Best Emetic. — Of powder of ipecacuanha, 20 grains ; tartarized 
antimony, 1 grain. Mix. 

Cordials, Stimulants, and Tonics. 

Stimulants rouse the energy of the system, and support the 

drooping powers of life ; tonics, also, counteract debility, and give 

strength and energy to the moving fibers, but do not stimulate 
materially. 



STIMULANTS. 697 

Stimulants. 



DOSEP. 



Arnica 5 to 10 grs. 

Horseradish 20 to 60 grs. 

Ammonia 5 to 20 grs. 

Assafetida 10 to 30 grs. 

Camphor 5 to 30 grs. 

s Cantharides ^ to 3 grs. 

Wine, capsicum, cloves, cinnamon; doses need not be specified. 

Musk 3 to 30 grs. 

Nutmeg 5 to 15 grs. 

Pimenta and pepper, according to taste. 

Mustard 60 to 240 grs. 

Valerian 30 to 120 grs. 

Ginger 30 grs. to a tea-spoonful. 

Ether 30 to 120 drops. 

Strong Camphor Mixture. — Of camphor, 25 grains ; spirits of 
■wine, 5 drops. Rub. Add gum arabic, powdered, half an ounce ; 
lemon-juice, half an ounce ; water, or mint-water, 7 J ounces. Mix. 
Two table-spoonfuls for a dose. 

Others make it thus : Of camphor, 12 grains ; carbonate of mag- 
nesia, 30 grains; rub together, and gradually add six ounces of 
water. 

Or this : Camphor, 60 grains ; carbonate of magnesia, J oz, ; 
rub, and add water, 1 pint. 

Cordial Mixture for Colic, Looseness of Bowels, and Pain in the 
Stomach. — Of aromatic confection, 180 grains; sal volatile, J oz. ; 
tincture of ginger, 120 drops ; oil of peppermint, 5 drops ; spirits 
of wine, 30 drops ; syrup of orange-peel, J oz. ; of pure wa.ter, 12 
ounces ; add tincture of cardamoms, J oz. ; of catechu, 120 drops ; 
cinnamon, 120 drops ; opium, 60 drops. Two table-spoonfuls for 
a dose. The oil is to be mixed with the spirits of wine first ; the 
confection to be mixed with water gradually. 

Camphor Julep. — Put a small bit of camphor into a pint of dis- 
tilled water. 

Stimulant Mixture. — Of carbonate of ammonia, 30 grains ; cam- 
phor mixture, 7 ounces ; syrup, or of syrup of orange-peel, 1 oz. 
Two table-spoonfuls for a dose, two or three times a day. 

Half an ounce of sulphuric ether may be added to this mixture 
to increase the stimulant power. 



AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Brandy Mixture (a cordial support). — Of brandy and cinnamon 
water, each 4 oz.; the whites of two raw eggs; sugar, J- oz.; oil 
of cinnamon, 2 drops. Mix. 

This is useful in the exhaustion of low fevers, and in great de- 
bility . 

Tonics. 

The bitters gentian, calumba, quassia, angustura, quinine, hop, 
oxide of zinc, sulphate of zinc, various preparations of iron. These 
are the most used. 

Infusion of Calnmba. — Of calumba root, cut into small pieces, 
J- of an ounce ; boihng water, 8 ounces. Let the whole stand for 
two hours or more on the hob in a covered vessel, and strain. A 
wine-glassfal twice or thrice a day. 

Infusion of Chamomile. — Of chamomile flowers, \ of an ounce ; 
boiling water, J pint. Let it stand as the foregoing. This is used 
cold in stomach complaints. In doses like those of calumba, it ia 
drank warm, either alone to excite gentle vomiting, or to assist 
the operation of other emetics. 

Compound Infusion of Gentian. — Of gentian root, cut small, 
dried orange-peel, each, 60 grains ; lemon-peel, 2 drachms ; boil- 
ing water, 13 oz. Let it stand like the calumba. Given in indi- 
gestion ; and wherever tonics are wanting, alkalies or acids may 
be added, 20 or 25 grains of the former to each dose, or ten drops 
of the dilute nitric acid. 

Compound Infusion of Orange-peel. — Of dried orange-peel, J 
oz. ; of recent lemon-peel, 60 grains ; of cloves, bruised, 30 grains ; 
boiling water, 8 oz. Let it stand for fifteen up to sixty minutes 
in a covered vessel ; when cold, strain. 

Infusion of Gloves. — Of bruised cloves, 60 grains ; boiling water, 
8 oz. Let it stand, like the preceding, for two hours, and strain. 

Stimulant, tonic and stomachic. 

Infusion of Cascarilla. — Of cascarilla root, bruised, J oz. ; boil- 
ing water, 8 oz. Prepare as before. 

Infusion of Peruvian Baric. — Of pale Peruvian bark, bruised, 
J oz. ; boiling water, 8 oz. Let it stand for two hours, and strain. 

In indigestion, and in convalescence, it is chiefly used as a 
vehicle. 

Infusion of Angustura Bark. — Of bruised angustura bark, \ 
oz.; boiling water, 8 oz. Prepare as before. 



TONICS. 599 

Compound Infusio^i of 31i'Rt. — Of dried mint leaves, i oz. ; boil- 
ing water, 8 to 10 oz. Boil, so as to strain off 6 oz. When cold, 
strain, and add of white sugar, \ oz. ; oil of mint, 3 drops ; dis- 
solved in J oz. of tincture of cardamoms. Mix. 

Infusion of Quassia. — Of quassia wood, cut small, 30 grains ; 
of boiling water, 8 oz. Let the fluid stand for two hours, then 
strain. 

A very pure bitter, useful in several disorders ; in bilious fevers, 
united with the carbonates of potash or soda, 20 or 30 grains to 
each dose ; in hysterics, camphor and tincture of valerian must be 
added ; in gout, with aromatics and ginger ; and in indigestion, 
united with 1 or 2 grains of sulphate of zinc, or with 8 or 10 drops 
of the mineral acids. 

Infusion of Valerian. — Of valerian root^ bruised and rubbed 
into a thick powder, J oz. ; of boiling water, 8 oz. Let it stand 
for an hour, and strain. 

In hysteria, 3 or 4 table-spoonfuls two or three times a day ; 
and the stomach will often bear valerian in this form vfhich it 
would not in any other. 

Quinine Mixture. — Of infusion of gentian or of orange-peel, 
7J- oz. ; sulphate of quinine, 8 grains to 20 ; dilute sulphuric acid, 
40 drops ; tincture of cardamoms, or of calumba, 2 drachms. An 
eighth part two or three times a day. This is often given in agues, 
and it may be given also in 

Infusion of Roses. — Of dried petals of the red rose, J oz. ; boil- 
ing water, 2J pints ; dilute sulphuric acid, 3 drachms ; sugar, IJ 
oz. Pour the water on the rose leaves, add the acid, let it stand 
in a glass vessel for half an hour or an hour ; strain, and add the 
sugar. 

This and the dilute sulphuric acid check and stop excessive and 
exhausting sweats. (See Consumption.) 

Dilute sulphuric acid is made by adding to IJ oz. of the strong 
acid, 14J oz. of distilled water ; 10 to 30 drops are a dose. 

Dilute muriatic acid is made by diluting the strong acid with 
equal quantity of distilled water, and dilute nitric acid by 1 oz. 
of strong acid to 9 oz. of distilled water. 

All these acids are tonics, the last especially; in fevers for 
drink, in bilious ailments, indigestion, etc., 10 to 20 drops. 

Compound Wine of Quinine. — Of sulphate of quinine, 20 grains ; 
of citric acid, 10 grains ; distilled water, 1 oz. Mix and dissolve; 



600 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

then add of good orange Y/'ine, 19 oz. A clear solution is formed; 
two table-spoonfuls for a dose, two or three times a day. 

Diluents. 

These increase the proportion of fluids in the system, and this 
can only be done by watery liquors. Water is the only diluent. 
Many medicines are given in certain diluents ; but many of these 
diluents have been mentioned in the first chapter, as barley-water^ 
toast water, etc. 

DiUEETICS. 

These augment the secretion of urine, and probably act by stim- 
ulating the secreting vessels of the kidneys ; the saline diuretics 
seem to act in this manner, being received into the circulation, 
and passing off through the kidneys. Diuretics separate the 
watery part of the blood, and thus they may promote absorption 
over the entire body. They are very efficacious in dropsy, and 
■when they are efficacious, they afford us the best way of removing 
dropsical fluid. 

But diuretics may often help us in other disorders, as in gravel 
and stone ; they may diminish fullness of vessels, and check pro- 
fuse perspiration. The chief diuretics which a non-professional 
person may use are, the acetate of potash (a very valuable remedy 
in many diseases), dose, 20 grains to 40 ; cream of tartar, dose, 1 
drachm to 8 ; carbonate of potash, dose, 10 to 30 grains ; nitrate 
of potash, dose, 5 to 10 grains ; the carbonate of soda, dose, 10 
to 20 grains ; sweet spirits of niter, dose, 30 drops to 2 drachms 
(this last is also very useful) ; broom-tops, dose, 10 grains to 60. 
Digitalis, and various other diuretics, shoufd only be taken under 
a medical man's superintendence. 

Forms of diuretic medicines : 

Infusion of Horseradish Root. — Of horseradish, sliced, and mus- 
tard seed, bruised, each 1 oz. ; compound spirit of horseradish, 1 
oz. ; boihng water (distilled), a pint. Put the root and seeds in 
the water, for two hours, in a covered vessel, and strain ; then add 
the spirit when cold. Dose, two to four table-spoonfuls three times 
a day, in dropsies, with debility, and after agues ; also in palsy. 
The acetate of potash, 30 grains to each dose, or from 30 to 60 
drops of sweet spirits of niter may be added. 



DIAPHORETICS, SUDORIFICS. 601 

Diuretic Pills. — Of blue pill, 30 grains ; compound squill pill, 
60 grains. Make into 20 or 24 pills. Two every night, but the 
gums must be watched so as to avoid a sore mouth. Stop as 
soon as the gums redden or swell, or there is a taste or smell in 
the mouth. During the administration of diuretics, keep the body- 
cool, and e^^rcise and drinking pretty freely of water and diluents 
will help. 



DiAPHOEETICS, SUDORIFICS, OR SWEAT PROMOTERS. 

These medicines increase the discharge by the skin, and so 
lower both fever and inflammation. The first two words have a 
similar meaning, only differing in the degree of the effects pro- 
duced — the first merely bringing gentle respiration on a dry, fe- 
verish skin ; the second exciting sweating. 

To produce their effect, the free drinking of tepid drinks or 
diluents should be encouraged ; and confinement to bed is usually 
essential, ot else lying down, covered by light blankets, for heavy 
blankets or coverings may rather check perspiration than promote 
it. The patient's shirt should be also of flannel or calico ; no cold 
drinks, nor acid drinks, are to be allowed. 

When the person has perspired long enough, or we wish to check 
it, caution is necessary ; removal from the damp bed, covering 
with a dry blanket, and drying with soft, warm towels are to be 
looked to, avoiding all draughts or admission of cold air. 

The real James's powder is one of* the best diaphoretics we 
can employ ; or, failing that, we may give small doses of tartar 
emetic, 1 grain of which may be dissolved in 8 ounces of distilled 
water, with some sugar (to taste), and one table-spoonful given 
every 4 hours. A slight feeling of sickness may come on first, 
and then the perspiration ; 5 to 10 grains of niter might be 
added to each dose, but in typhoid fever these antimonials are too 
debilitating, and can, in such cases, only be given while the 
strength remains unimpaired, or while the fever is high. 

Another useful remedy is the liquor of acetate of ammonia. 
This is made by adding 30 grains of carbonate of ammonia, 2 
ounces of acetic acid, or 1 ounce to 15 grains of ammonia. The 
dose of this is 1 or 2 drachms, 60 to 120 drops every third or 
fourth hour, with syrup of orange-peel, or simple syrup; and 
niter may be added to each dose of this, as in the preceding case. 



602 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Some give carbonate of soda or potash, 30 grains, with tar- 
taric or citric acid, or lemon-juice, enough to prevent any effer- 
vescence; then add syrup; and the ounce or ounce and a half of 
vehicle may be either camphor mixture, or mint, or peppermint, 
or plain water. When there is much pain, 15 to 20 drops of tinc- 
ture of opium might be added, at bedtime chiefly. 

Another Draught, — Of carbonate of ammonia, 10 grains ; of 
lemon-juice, 2 drachms ; of syrup, 60 drops ; water, or mint-water, 
an ounce. 

Guaiacum Draught. — Of resin of guaiacum, 10 grains; of 
Dover's powder, 5 grains; of tartar emetic, one-eighth of a grain; 
of syrup, 1 drachm ; of water, 1 ounce ; in acute rheumatism. 
But if we give this often during the day, the dose of Dover's 
powder should be 2 grains only. 

Alteratives. 

These medicines act slowly, and are meant to effect a gradual 
change in any morbid 6r faulty secretion, or in fevers, or inflam- 
mations. The best of all is the form of powders, recommended 
in the Fourth Chapter, against inflammations, especially of the 
chest and some inward parts. Where the lancet can not be effi- 
ciently employed, these powders must form the chief reliance. 

Poivders against Inflammations, and some Fevers. — Of calomel, 
32 grains to 64; of tartar emetic, 1 grain; rub these very well 
together, then add of poWdered tragacanth or gum arable, 60 or 
80 grains ; mix again by thoroughly rubbing in a mortar ; then 
divide into 16 powders; one every three or four hours, until a 
coppery taste, or swelled or reddened gums begin to appear ; then 
stop, and give a gargle of tincture of myrrh, wdth alum or borax, 
and syrup, or honey and water. 

If these calomel powders cause purging, add powder of chalk 
and opium, 2 grains, or else one quarter of a grain of opium to 
each dose. 

If the inflammation is in an organ essential to life, such as the 
brain, or lungs, or is violent in degree, give the 4-grain powders 
every three hours, so as to affect the gums as soon as possible, 
only taking care to' prevent salivation to a great extent. Take 
care to avoid cold air, or cold or damp, while the person is taking 
or feeling the effects of these powders. 



NARCOTICS AND ANODYNES. 603 

After salivation, besides a gargle, we should give an ounce of 
bitter infusion of calamba, with an ounce of camphor mixture, 
and 20 drops of sal volatile, two or three times a day, after the 
inflammation is gone — not before. 

Another Alterative Powder. — Of metallic mercury and of levi- 
gated (rubbed into powder) antimony, each, 1 ounce ; of sulphur, 
half an ounce. Mix. Of this, 15 to 20 grains is a dose, two or 
three times a day ; and it is given in many eruptions of the skin, 
of a chronic nature, not attended with fever. 

The gray powder, which consists of metallic mercury, 3 ounces, 
rubbed together with 5 ounces of prepared chalk until the globules 
have all disappeared, is also an alterative. 

Other alteratives, at least such as are called alterative, may be 
mentioned, but it would not be practically useful to do so. 

Narcotics and Anodynes. 

These are remedies which diminish sensibility and irritability, 
abate pain, and induce sleep, or sometimes a sort of stupor. 

The chief of these are opium, powdered, half a grain to 1 or 
more; or the acetate or hydrochl orate of morphia — of the acetate, 
one-sixth to one-half grain ; of the other, one-fourth to one-half 
grain for a dose. Henbane (tincture of), 20 to 60 drops ; tincture 
of opium, 15 to 40 drops ; tincture of the seeds of meadow saffron; 
belladonna (dangerous), and anconite (also dangerous, except under 
proper care). Compound powder of chalk, with opium, contains 1 
grain of opium in 40, so 20 to 30 grains is the dose. Dover's 
powder contains 1 grain of opium in 10, and 5 grains is the dose. 

Against gout, especially, and the pains of rheumatism, the tinc- 
ture of meadow saffron is found very useful. Take of the seeds of 
meadow saffron half an ounce, bruise them, and put them into 4 
ounces of spirits of wine ; let it stand 10 or 14 days, then strain ; 
20 drops, eight times a day, with 20 or 30 grains of carbonate of 
potash or soda ; watch the effects, and as soon as depression of 
spirits, or relaxing sweats, or looseness of the bowels come on, 
discontinue ; to be given in water, two or three times a day. 

Tincture of opium is made by cutting 1 ounce of crude opium 
into small pieces, and putting them into 16 ounces of proof spirits 
of wine; let the liquid stand for 10 or 14 days, shaking often; 
then strain for use. 



604 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



Antispasmodics 

allay inordinate muscular action and violent pain, without excit- 
ing insensibility, sleep, or stupor, as narcotics sometimes do. 

Ether (sulphuric),, 80 drops to 60 ; musk, 1 grain to 60 ; liquor of 
ammonia, 10 to 15 drops ; assafedita, 5 to 20 grains ; carbonate 
of ammonia, 5 to 20 grains ; galbanum, 10 to 30 grains ; sagape- 
num, 10 to 30 grains; valerian, 20 to 40 grains; camphor, 1 to 20 
grains; cajeput oil, 1 drop to 5. 

These medicines are serviceable in cases of hysteria, and in 
disorders affecting chiefly the nervous system, as St. Yitus's 
dance, etc. 

Astringents 

corrugate the parts to which they are applied. They are used 
both internally and externally — in bleedings, discharges, in fluxes, 
in whites, etc. 

,, DOSES. 

Dilute sulphuric acid 5 to 30 drops. 

Alum 10 to 20 grs. 

Sulphate of zinc 1 to 20 grs. 

Sulphate of iron 1 to 5 grs. 

Sulphate of copper J to 2 grs. 

Sugar of lead ^ to 2 grs. 

Extract of catechu 10 to 20 grs. 

Kino 10 to 60 grs. 

Logwood (extract) 10 to 30 grs. 

Oak bark , 10 to 30 grs. 

Galls 2 to 10 grs. 

Lime water 2 to 8 oz. 

Whortleberry leaves 10 to 60 grs. 

Bistort root 10 to 60 grs. 

Pomegranate bark 20 to 60 grs. 

Tormentil (decoction of) -J to 1 J- oz. 

Infusion of Buchu Leaves.^-0^ buchu leaves, 1 ounce ; boil- 
ing water, 1 pint ; to stand for 4 hours, then strain ; 3 or 4 
table-spoonfuls, two or three times a day, in diarrhea, dysentery, 
etc. A light tonic, slightly diuretic, and warmly aromatic, from 
the volatile oil in the glands of the leaves. 

Decoction of Whortleherry. — Of whortleberry leaves, 1 ounce ; 
water (distilled), a pint and a half; boil down to a pint, and strain. 



ASTRINGENTS. 605 

Half an ounce to 2 ounces, two or tliree times a day, in affections 
of the urinary organs, and in exhaustion from discharges from 
those organs. 

Infusion of Pareira, — Of pareira, one-half ounce ; of boiling 
water, 9 ounces ; let it stand for two hours, and strain ; 2, 3, or^4 
table-spoonfuls twice, or thrice daily, in irritation of the bladder, 
with discharge from it; in catarrh, too tonic slightly, and diuretic. 

Infusion of Rhatany. — Of rhatany, 1 ounce ; boiling water, 1 
pint ; after 4 hours, strain. Tonic and astringent in diarrhea, and 
as a gargle in relaxed throat. 

Compound Infusion of Catechu. — Of catechu, three-fourths of 
an ounce ; bruised cinnamon, 1 drachm ; boiling water, 1 pint ; 
after 2 hours, strain; 2 to 4 table-spoonfuls after every loose 
Stool in diarrhea, or every three or four hours. 

Compound Infusion of Linseed. — Of linseed, bruised, three- 
fourths of an ounce ; liquorice-root, bruised, one-fourth of an 
ounce ; boiling water, 1 pint ; after 4 hours in a gentle heat, 
strain. A tea-cupful occasionally, in catarrhs, coughs, difficulty 
in making water, and in irritability of the bladder. 

Decoction of Liverwort. — Of liverwort, 5 drachms ; distilled 
water, a pint and a half; boil to one pint, and strain; one-half 
ounce to two ounces, two or three times a day, in coughs, con- 
sumption, loss of flesh, whooping-cough. If we want to destroy 
the bitter taste, steep the liverwort in several waters, adding to 
each 10 grains of carbonate of potash, before boiling; but some 
object to depriving it of its bitterness. This decoction possesses 
some nutritive powers. 

Decoction of Sarsaparilla. — Of sarsaparilla, one and one-quarter 
ounce ; boiling water, one pint; boil to half a pint. Of sassafras, 
Guaiacum, and liquorice-root, each, one-half ounce ; mezereon, 60 
grains ; boil 15 minutes, and strain. In chronic rheumatism, 
leprosy, some liver affections, 2 table-spoonfuls, or 3 or 4, two or 
three times a day. 



606 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



DIRECTIONS TO EMIGRANTS. 

To emigrants to various parts of this country, and of the world, 
the following directions may be found useful : 

Wherever the emigrant fixes, he should try to buy or rent land 
which is cleared, for clearing land is always dangerous. Agues, 
fevers, etc., are likely to ensue, even when considerable precau- 
tions are taken. 

The laboring emigrant should likewise avoid laboring early in 
the morning, on an empty stomach ; he should take some tea or 
coffee, with meat, bread or bacon, before going out, especially in 
aguish or feverish districts, for morning and evening are the times 
in which the bad air lies low upon the ground, and is endowed 
with most power to produce injurious effects on the constitution. 
(See First Chapter, where Malaria is described.) 

No forethought, no trouble can be thrown away which are de- 
voted to prevent disease ; the health once impaired may not easily 
be reestablished, and without health nothing can be done. 

Whenever the emigrant can choose his site, he should avoid low, 
swampy grounds, especially for fixing his house ; clayey soils and 
alluvial earth in the bottom of valleys are dangerous, particularly 
if exposed to the rays of the sun in a hot country ; pools and 
ditches containing stagnant water, rice grounds, and all marshy 
surfaces which are at times covered with water, and then left dry, 
while a hot sun is causing a rapid evaporation from them, are very 
productive of fevers, both continued and intermittent. (Refer to 
Malaria in the Index.) 

Those who are robust and of a plethoric (full) habit of body, are 
often able to resist those influences which cause ague for a longer 
time than those who are weak and debilitated ; but when to the 
usual marsh miasms are added the efiluvia of decayed animal sub- 
stances, the former persons seem to be more susceptible, and are 
sooner attacked by continued fever — often of a fatal kind — than 
the latter; wherefore, they should be careful to avoid a too stimu- 
lating mode of life ; while those who are of weak and feeble habit, 
should keep up strength and power by a generous mode of living, 
though a simple one. 



DIRECTIONS TO EMIGRANTS. 607 

A daily pill of one grain or two grains of quinine during spring 
and autumn, or while fever is prevalent, would help to protect from 
ague and from fever; and all who are living in aguish situations 
should not neglect to take this precaution, at the same time avoid- 
ing every thing that would lower the vital powers. 

If any one has been exposed to infection, and feels chilly, or a 
loss of appetite — as if about to be attacked with fever — the attack 
might be averted sometimes by an emetic, or by a warm aperient, 
and going to bed, followed by wine, or brandy and water, or by 
quinine in camphor julep, etc., taken every four hours, until a 
perspiration breaks forth, when all danger of suffering from a 
tedious fever is at an end. F^ver may thus be often arrested 
during the stage of invasion, or up to the beginning of the state 
of hot skin, thirst, and of what is called high or burning fever; 
but when once this period of reaction is attained, the fever will 
take its course, and all that then can be done is to guide it to a 
safe termination, by moderating too much action, or by gently 
supporting the strength — not so as to stimulate — when there is 
too little. 

Inflammation of the eyes, which disqualifies for work, and may 
end in loss of sight, is to be guarded against, by wearing always, 
or when working in, or exposed to the sun's glare, or to clouds 
of dust, fine wire-gauze goggles ; and dysentery, which is another 
scourge of the emigrant, is to be kept off by flannel worn round 
the abdomen and loins. 

In all cases, and in all parts of the country, the diet should be 
simple, yet nutritious ; and intemperance of every kind must be 
avoided. Every act of drunkenness may be considered as verify- 
ing the old saying, of putting an additional nail into one's coffin. 

This is the one debasing and brutalizing habit, which, more than 
any other, will ruin the best hopes and prospects ; which will not 
only prevent him from rising in life's social scale, but will gradu- 
ally lower him until he is a lost and ruined man. This is a habit 
of intoxication, a habit which in many is begun early in life, and 
never left off, except in some rare instances. 

Among other evils, it is the cause of an appalling and fatal dis- 
ease, called Delirium Tremens, which is thus described: 

It begins with lassitude, general indisposition, a feeling of distress 
at pit of stomach, a want of appetite, nausea, and vomiting, giddi- 
ness, want of sleejJ, anxious countenance, and tremor of the hands. 



608 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

In a day or two tlie countenance shows- alarm and suspicion; 
the eyes are cast about, or J&xed in a singular manner ; the trem- 
bling of the hands increases ; irritability comes on, with restlessness. 
And now, the miserable victim becomes loquacious ; says he is very 
well, though he is tormented with thick-coming fancies, and visions 
of dogs, of cats, of snakes, rats, mice, insects, and vermin crawl- 
ing over him, or over hi& bed ; or else he fancies people are coming 
to rob him, etc. To avoid these illusions he calls for aid, or tries 
to escape by door or window — is greatly agitated, vociferates, 
raves, and threatens. He is never at rest, can not bear contradic- 
tion, and sometimes becomes furiously delirious. 

The pulse varies in these attacks; it may be, in first attacks, 
and in young, full-blooded subjects, hard, full, and frequent, but it 
is usually soft, full, and quick, without strength. The skin is of 
its natural temperature, though constantly perspiring ; the tongue 
is humid, and covered with a white fur, and the bowels are torpid. 
There is a thirst, demanding cold drinks constantly. 

These attacks vary much ; some may be slight, and marked by 
tremors of the hands, threatenings of delirium, illusions, and want 
of sleep, which pass off in a day or two ; in others, these symp- 
toms may continue longer, for six or seven days, or longer, and 
be more severe ; while, in the worst cases, there may be ungov- 
ernable mania. And if the attack continues above a month, the 
mind may become permanently alienated ; in full habits, convul- 
sions, or supervening apoplexy, have, in a great many cases, 
proved fatal. 

I have attended several cases occurring in the same person, and 
have seldom witnessed recovery from the third attack. Many a 
young man has been carried off, before he had attained his thir- 
tieth year, by this fell destroyer ; and those who have suffered 
from disease of liver, or of other parts, have little chance of es- 
cape. I have seen it in sailors, who have, it may be, not long re- 
turned from a voyage ; have been ever since, almost living in a 
grog-shop, and eating little or nothing of solid food for days to- 
gether ; and who, notwithstanding a good constitution, and an age 
almost youthful, are reduced to a state truly awful to behold. 
These thoughtless men are unintentional suicides. 

Causes. — Intoxication, occasional or habitual ; sudden abstinence 
from drink, mental exhaustion from anxiety or study, great losses 
of blood. The male sex and summer season predispose. 



DIRECTIONS TO EMIGRAN 609 

Treatment. — To procure sleep is the grand .^u and many 

a doctor says of such patients, they must eil • die. 

Tiicre may be some cases of full habits, a cks, which 

threaten apoplexy, where some blood mig._ ^_ .., . away by 
lancet, cupping, or leeches ; but all depletions are badly borne in 
almost ail cases. 

My method is, to get the bowels cleared of any irritating, foul 
secretions, by castor-oil and injections, and then give opium as 
the sheet-anchor. This is a good form : 

No. 241. Carbonate of ammoniate 5 to 10 grs. 

Tincture of opium 30 to 60 drops. 

Water, or of camphor julep .... 1 oz. 
Mix. 

To be given every three or four hours, until sleep comes on. 

Others give a grain of opium every hour, and some have given 
four grains every two hours. From twenty to thirty grains have 
been swallowed, in some cases, before sleep came on. The smaller 
doses should be begun with. 

The diet must be light and unirritating — animal broths, for in- 
stance. Some give drinks of spirits to keep up the stimulus ; this 
I deem unnecessary where we are giving ammonia, camphor, and 
opium. 

One eminent physician advises us to clear the bowels first, then 
to give three grains of solid opium ; and in two or three hours, if 
no sleep ensue, give one grain every hour till the patient sleeps ; 
but all rely on opium. It may also be administered in injections. 

Cold lotions to the head may be applied, if the head is hot. 

We must take care not to mistake this disease, which probably 
consists in a state of nervous irritation and exhaustion, for an at- 
tack of inflamed brain ; for then we should bleed, purge, leech, 
and lower the man speedily into his grave. 

Delirium tremens is characterized by full, soft pulse ; by a 
tongue moist and creamy ; by a sweating skin ; by a pale counte- 
nance ; by tremors or tremblings, and by peculiar illusions and 
delirium. Inflammation of the brain is attended with very difi"er- 
ent symptoms. 

The two chief dangers to life from disease may be comprised 

under inflammations and fevers; and should a person be seized 

with pain anywhere, say in the right side, about the middle of the 

ribs, the great point to ascertain will be, whether it is a symptom 

39 



610 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

of inflammation of the chest ; if it is, there is no time to lose, and 
the most energetic means must be resorted to. 

How, then, is inflammation of the internal organs to be ascer- 
tained by a non-medical person ? 

We shall always find it accompanied with fever, which arises 
not long after the pain has commenced, viz. : white tongue, quick 
pulse, etc., and by disturbance of the function of the part aifected. 
For example, the pain in the ribs is accompanied by fever symp- 
toms, and by difficulty of breathing, increase of pain on breathing, 
perhaps cough, and expectoration. Again, if there is pain in the 
head, as a sign of inflamed brain, we shall have thirst, hot skin, 
quick pulse, and the other signs of fever, mixed up with red, fer- 
rety eyes, delirium, or other signs of disturbed function of the 
brain. Common headache is not usually attended with fever. 

So of inflammation of other parts, the situation of the pain, and 
the presence of fever symptoms, together with those of disturbed 
function of the part, give warning of inflammation. 

In such cases, medical men use the lancet more or less freely, 
according to the organ inflamed, the intensity of the inflammation, 
and the state of the patient, as to strength ; but as this can not be 
done by emigrants, nor by any one who is not professionally edu- 
cated, they must rely on the powders, which have been here called 
powders against inflammations and fevers, consisting of calomel, 
two or three grains each, and one-sixteenth of a grain of tartar 
emetic. These powders must be given every three or four hours, 
till the gums are becoming tender or sore or swelled. If they 
purge, the looseness must not be stopped. The diet must be low, 
so long as the inflammation continues. 

It is true, a sore mouth may result, but then the powders may 
have prevented loss of life. 

The reader is referred to each article for instructions as to 
treatment in Chapters IV, V, and VI. (See, also, Index.) 



SICKNESS, OR SICK STOMACH. 611 



CHAPTER YIII. 

SPECIFIC DISEASES 

Milk Sickness, or Sick Stomach. 

The milk sickness has long been known in some sections of 
the United States, and these are much more numerous than either 
books or journals have recorded. It is true that it exists at cer- 
tain times of the year, in all the States south of Maryland to the 
Gulf of Mexico, and those whose base rest on that gulf, and from 
thence through much of the interior valley of the Mississippi to 
the great lakes on the north. It is fortunate that the localities 
where this grave form of disease is found, are limited in extent to 
small spaces. It is not always found in swampy situations, but 
occasionally occurs on ridges, and level lands considerably ele- 
vated ; it, however, is but seldom met with on prairies, away from 
timber, or on grounds that are under cultivation. From what we 
have seen, we are induced to believe that the natural growth of 
timber and jungle are necessary to its production. In the great 
prairie regions of the Mississippi Valley, it is seldom found, but 
in the neighborhood of the timbered lands, along the streams, or 
on the low lands bordering the prairies, it is more frequent. 

But more of the history of the affection when we come, to con- 
sider its remote causes. We, in the mean time, will state what 
the symptoms generally are. Dr. Drake informs us that it ''al- 
most invariably commences with general weakness and lassitude, 
which increase in the most gradual manner. About the same time, 
or soon after, a dull pain, or rather soreness, begins to affect the 
calves of the legs, occasionally extending up the thighs. The ap- 
petite becomes rather impaired, and in some cases nearly suspended; 
sensations of a disagreeable kind affecting the stomach ; upon taking 
a little food, however, a greater disposition is generated, and more 
agreeable feelings are introduced by it throughout the whole sys- 



612 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

tern." Costiveness now is obstinate, which continues through the 
disease. The patient is much disposed to sleep. The pulse is fre- 
quent, round, and full in this stage, as well as tense. Should the 
patient now exercise, it has an unfavorable effect, and has a strong 
tendency to produce vomiting. This symptom almost certainly 
occurs in this affection, and soon reduces the strength very much, 
and but too often continues long after the violence of the symp- 
toms has measurably abated, of which we shall see more when 
we come to the consideration of the disease as we found it. It 
must, however, be. admitted that the symptoms are not very uni- 
form, and we believe they often indicate, from the beginning, 
much debility, with a frequent and weak pulse, connected with a 
dry and dark coating on the tongue. 

Before laying down the plan of treatment we intend to advise, 
we shall make some observations on what we believe is the true 
nature of the disease, and to do this we w^ill first observe that it 
was our lot to spend a few years of our life in a part of the 
country where the malady was occasional, so that we saw a number 
of cases, and heard much said about the disease, both as to its 
effects upon the human subject and upon the lower animals. It 
was, forty-five years ago, a general belief, wherever milk sick- 
ness existed, that it was caused by some poison eaten by the 
lower animals, and that the meat of these, by being eaten by any 
animal, would sicken it, and often cause death. It was believed, 
too, that the milk of diseased animals, when sucked, would destroy 
or sicken their young ; and that the milk of the cow was the usual 
medium by which the human subject became affected with the mal- 
ady, and that sometimes people were sickened by eating the flesh of 
animals affected by this singular disease. Well, all these opinions 
were considered with much care by the writer; constant inquiry was 
made of those who had had, or had seen, the milk sickness, and all 
that he could learn was an obstinate belief that the human subject 
only became affected through two mediums — either by the use of the 
milk of the cow, or of diseased meat of some kind. He believes 
that the flesh of the hog was not charged with this offense, and 
thinks that beef was alone believed, with milk, to cause the dis- 
ease. Now, it is nearly certain that both milk and beef, with 
probably some other kinds of meat, had the power of producing 
the sick stomach, but whether these ever produced that particular 
malady which so often proved fatal, is a question which the writer 



MILK SICKNESS, OR SICK STOMACH. 613 

did not then decide in his own mind, nor has he been able to do so 
since. It is, however, true that calves took the disease and died in 
cases where they sucked the dam. This fact would go some distance 
in proving that milk can- communicate the disease to other animals. 
It was believed, in those days, that cows that were milked were api 
to recover when their milk was regularly drawn off; there can, 
indeed, be httle doubt that in all cases of fever, either in the hu- 
man or brute subject, that the frequent abstraction of the milk, 
where the young are being nourished by it, will render the case 
less dangerous. 

But, as to the supposed fact that the human subject never has 
the sick-stomach disease unless where either meat or milk has been 
used as food, the writer feels that, so far as regards himself, he 
is satisfied that the human race are capable of being acted upon 
entirely outside of eating meat or drinking milk; for, during the 
summer of 1821, and ensuing winter, he treated two cases of this 
disease in men, both of whom had refrained from milk, butter, or 
meat for months. In these cases, the patients allowed their fami- 
lies to use milk, butter, etc. We recollect perfectly that we then 
thought the disease was well sent on these men, because of their 
selfishness toward their families. In both these cases there was 
a great sense of burning in the stomach, with soreness over it, and 
the rejection of both drink and food a very short time after being 
swallowed. One thing which we particularly remarked in these, 
as in a few other cases, was the coolness of the skin, and weak- 
ness of the voice. But more of these cases when we come to the 
treatment. Now, as these cases satisfied us as to the capability 
of man to take the sick-stomach disease independent of other ani- 
mals, we more particularly turned our attention to the consideration 
of what the real cause was, and, in doing this, we found that, although 
the affection occasionally occurred on dry ridges, or on dryish flat 
lands, yet these lands were in most part covered with timber; and, 
although they produced sorhe nourishment for cattle, it could not 
be compared in its nutrient qualities with grass grown where there 
was a full admission of the sun's rays, and the surface generally 
dryer. It was known, too, that the disease was more common in 
wet or moist situations, and near swamps, than in drier localities. 
These facts led us to the conclusion that the real cause must be 
from exhalations from the surface of the earth in certain localities, 
which had a peculiar influence of a deleterious nature on the health 



614 AMERICAN HOUSEHOLD BOOK OF MEDICINE 

of animals, and, in short, the affection was a fever mostly affecting 
the stomach, bowels, etc., and that the nervous system was more 
affected than is general in other fevers. These conclusions led us 
to the opinion that it was very possible that the disease might be 
brought on, or hastened, by the use of the flesh of diseased ani- 
mals, or by the use of their milk, and that in these latter cases 
the disease might be more confined to the stomach than when the 
affection was produced by the local influences which produced 
them in the lower animals, or in man. We know that great changes 
have occurred, within our time, in the interior Valley of the Missis- 
sippi, as to the intensity of the remitting and intermitting fevers. 
There are now fewer cases of a malignant character than there were 
forty years ago, and in many places these fevers have disappeared, 
or become so continued in their tj^e that the inexperienced are 
unable to designate them from the continued or typhoid fever of 
higher and dryer localities. We once saw two fatal cases that 
were called cases of milk sickness, which ran their course in 
about three days. These cases were then, in our opinion, those 
of the congestive type of fever ; so that, really, not a few of the 
cases that passed for milk sickness in early times, in the Misssis- 
sippi Valley, were simply those of malignant bilious fever. In 
those days, both the doctors and people had got it into their heads 
that the lower animals ate some wild weed, which caused the mal- 
ady ; and it would have been about as easy to have convinced them 
that no witches ever lived, as to make them believe that what was 
called the milk sickness was but a disease orrowino; out of the com- 
mon causes of fever, produced by the unhealthy exhalations from 
the earth. None of them could show the poisonous weed ; but 
they knew that cattle which were better fed than those that ranged 
the forests were seldom affected by the disease, and that their milk 
was more wholesome. Those who have observed cattle that ranged 
the woods in early times, in those regions which have produced 
the disease under consideration, know how thin they always were, 
and know how much they diminished in size after two or three 
generations. It may be said that no such leanness ever existed 
among the cattle that belonged to the prairies, which is true ; but 
those cattle only have the disease that are allowed to stray among 
the timber, where the land is low and often wet, where people as 
well as the lower animals become diseased ; because it is a fact 
that, in the prairie regions, people who live in or near the tim- 



MILK SICKNESS, OR SICK STOMACH. - 615 

bered lands are much more apt to sicken with bilious diseases than 
those who live in the open prairie. In these latter situations, people 
seldom or never have the milk disease, and not frequently remitting 
or intermitting fevers, when compared with those who live in or near 
the timber. Another argument is, that in those parts of our coun* 
try where remitting and intermitting fevers are seldom found, the 
milk sickness is equally unknown. These diseases have scarcely 
an existence on the western slope of the Alleghanies, from their 
approaches to Lake Erie to Tennessee ; and, although the milk 
sickness sometimes appears where the ague but seldom occurs, 
the latter is never far off, and the regions where the former is 
found are nearly all subject to malarious diseases; so that it 
seems evident that there is a close connection between the re- 
mote causes of the apparently different affections. But we must 
hasten to the consideration of the treatment of the disease. 

Treatment. — We shall first give the views of Professor Dickson, 
of the Jefferson Medical School of Philadelphia, as to the treat- 
ment of milk sickness. This physician has the following observa- 
tions : " If a case of this nature were to come under my care, 
I would prefer to treat it as the effect of an acute poison, and one 
for which no antidote was known. If the stomach were emptied 
spontaneously of the deleterious food taken, I would wash it with 
draughts of warm water, or ipecacuanha. I would apply leeches, 
or cups, to the epigastrium, or abdomen, and give the patient ice 
and cold fluids. The first stage being past, and excitement con- 
tinuing and becoming more general, I would resort to venesection, 
and administer such purgatives as could be best borne, perhaps 
preferring castor-oil, aiding them with proper enemata (injections). 
When the bowels had been rendered soluble, I would depend for 
further advantage upon the mercurials, combining them with mod- 
erate doses of opium, and persisting until the gums should become 
spongy, and the salivary glands be urged to increased secretion." 

Now, this treatment proposed by Dr. Dickson is, in our opinion, 
in part good — that is, so far as the mercurial course goes ; but his 
first proposition to vomit, for the purpose of emptying the stom.- 
acli by any emetic, we can scarcely think necessary, as the stomach 
almost always throws off whatever it contains, and continues to do 
so for days, or even weeks, in chronic cases. The leeching and 
cupping over the stomach, we think, a good plan; and afterward a 
small blister, especially in chronic cases, on the abdomen. We 



616 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

must, however, give the treatment according to our own views, and 
which we believe is now the practice of many physicians of the 
present time. 

When an individual, living in a neighborhood where the milk 
sickness occasionally occurs, and when it is epidemic among the 
lower animals, is attacked with an affection having the character- 
istics of this malady in its acute form, we would advise that he 
should take ten grains of calomel, with a grain of opium, every 
hour, in the form of pills, until four doses be taken ; and, in the 
mean time, if fever with headache is present, a moderate quan- 
tity of blood should be taken from the arm, while cups should be 
applied over the region of the stomach, either dry or with scari- 
fications. During the three or four hours in which the above 
treatment is being carried out, no more is necessary than that the 
drinks should be regulated as to quality and quantity. Small 
pieces of ice or iced water should be given every fifteen or thirty 
minutes; or, what would be better, the effervescing draughts, par- 
ticularly that composed of a table-spoonful of lemon-juice, with 
two table-spoonfuls of water combined with twenty grains of bi- 
carbonate of potash. The lemon-juice, the water, and potash must 
be brought together, and drank while effervescing. This amount 
may be given every hour or two, and often with great advantage. 
Other forms of effervescing mixture can be found under the proper 
heads in this work, which would answer nearly as well. Now, 
after the patient has gone through four hours' of this kind of treat- 
ment, and is found to be better, it will then be proper to give an in- 
jection of warm water and common salt, castor-oil, or Epsom salts, 
every few hours, for the purpose of aiding the other prescriptions 
in bringing about purging. The purgative medicines to be pre- 
ferred, after the opium and calomel, are the senna, manna, and salts, 
and the compound extract of colocynth. Two grains of this ex- 
tract, with half a grain of calomel, should be given every four 
hours, until purgation is brought about. Severe or drastic pur- 
gatives are always borne badly where there is much irritation of 
the stomach or bowels, but any of the milder kinds could be used 
without danger; and of them all, calomel is the best, and should, in 
case of the continuance of the vomiting, be given every half hour — 
grain doses, combined with the fourth of a grain of opium, so long 
as the irritation continues, or until thirty or forty gr^jns of the 
calomel have been taken, when we must rely on other means^ 



MILK SICKNESS, OR SICK STOMACH. 617 

such as blistering over the stomach, a continuance of the injec- 
tions, etc. 

It should ever be recollected that salivation must be considered 
the main means of cure. Where the disease runs into the chronic 
form, those remedies must be relied on which will give strength 
without irritation, and conduce most to quiet the stomach. Mor- 
phine, in moderate quantities, will have to be resorted to at night ; 
and, if possible, quinine, in small doses, should be given three or 
four times a day, in the form of a pill, powder, or solution. The 
quantity, probably, should not be more than one or two grains at a 
dose. Then the watery effusions of the Peruvian bark, when they 
can be borne, with the addition of sulphuric acid, would be found 
to be serviceable. 

The chronic form of this disease comes on by vomiting, either 
less or more frequent, and with the affection confined very much 
to the stomach. We shall speak now of the little we saw long since. 

In the two cases which we have before mentioned, we were not 
called immediately, for they both had existed several days before 
any prescription was made. The symptoms, however, were as 
urgent as at the first. Obstinate constipation existed, and the re- 
jection by vomiting of every thing taken into the stomach. Under 
these circumstances, we administered small doses of calomel every 
half hour, combining with these a little compound extract of colo- 
cynth. One grain of the former, with half a grain of the latter, 
is the dose. This course was continued, in each case, for forty- 
eight hours. At the same time, a blister was applied over the 
stomach in each, and injections were occasionally directed. One 
case was relieved within three days by purging, and the other in 
about four days. The medicine was given in pills, made freshly, 
but as solid as possible. The use of the mercury was continued 
until the salivary glands were excited in each case. After this, 
tonics of the Peruvian bark were used, until complete recovery 
took place. The bowels, in the mean time, were properly regu- 
lated. 

A case still more chronic than these fell under our care, not far 
from the same time. In this case, the surface was below the nat- 
ural standard as to heat ; the pulse was low, the voice feeble ; there 
was constant burning in the stomach, and incessant vomiting after 
eating or drinking, until every thing was ejected. The patient 
only occasionally escaped this, when food and drink would be re- 



618 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

tained a short time. It was not until the disease had lasted some 
eight or ten weeks that we saw this patient. He was then vom- 
iting dark and grumus matter, which satisfied us that there was 
present chronic inflammation of the stomach. Yerj little was ad- 
vised, as no medicine could benefit him. The emaciation was 
extreme, and the bowels still constipated. 

The year before we saw these patients, we had seen two cases 
in one house, which had come on in the most violent manner, and 
both had become comatose in a short time, and died about the en4 
of the third day. At the time we saw them, the skin answered to 
the yellowness of the yellow fever, Now, this condition of the 
skin, and other considerations, brought us to the conclusion that 
malignant bilious fever existed in both cases, as we have noticed. 

We would then advise, in all chronic cases, small and repeated 
doses of calomel, with small quantities of opium — one grain of 
the former and a fourth of the latter, every half or every hour, 
until the vomiting should cease. We would leech and cup over 
the stomach once or twice, and whatever drink should be given, 
would be the effervescing draughts, as directed in the bilious fe- 
vers. These might be given once an hour, if borne well. During 
this time, we would direct an injection of salt and water every four 
hours, and after the calomel and opium had been given, until some 
forty grains of the former had been taken. We would then lay 
the opium aside, and combine some active cathartic with the calo- 
mel, in small doses, every two hours, until purging was brought about. 
After this, we would give quinine, in medium quantities, until 
the strength is measurably restored. Not a few things will occur 
in the treatment of this afi"ection that will require variation from 
these medications, yet we would long persevere with the calomel 
before we would give the case up. 

Phlegmasia Dolens, or Milk Leg. 

This disease mostly occurs in women after delivery, though there 
are instances where it attacks women who have never borne chil- 
dren, and even men ; but these instances are so few that the affection 
has received the name of milk leg, because it so generally begins 
after confinement, and that, too, within from four to fourteen days. 
It sometimes, however, does not appear until a later period. In most 
instances it is ushered in by fever and chill, but, preceding these 



PHLEGMASIA DOLENS, OR MILK LEG. 619 

by one or more days, there is pain in the side of the abdomen and 
near the groin, with some soreness and distension. The pain soon 
fixes itself in the groin, and afterward extends down the thigh, and 
even to the calf of the leg. Within some hours after it has as- 
sumed these characteristics, the limb on the same side begins ifO 
swell, and, within a very short time, is twice the natural size. The 
labium on that side is involved in the swelling to a painful extent. 
There is great soreness, as well as pain of the limb. It is tense to 
the touch, and is smooth and shining, unless on the inner side of 
the thigh, and above the middle, where there is sometimes redness, 
mostly confined over the great vessels, which generally become hard, 
and can be felt like a cord. The disease may now be said to be 
completely formed, and generally goes on for about two weeks be- 
fore there is much mitigation, when the pain and soreness begin 
to subside, being followed by a continuance of the swelHng, vdth 
still some pain for weeks, the swelling often continuing through 
life, but in so tolerant a condition that the patient comes to bear 
it with comparative ease, but it is still a drawback on her general 
health. 

The remote cause of phlegmasia dolens is mostly inflammation 
of the veins of the womb, which occurs after delivery, and which 
irritation or inflammation is eventually transferred to the great 
veins of the groin, that so act on the free circulation of the blood 
in the limb on the afi'ected side that the whole train of symptoms 
constituting phlegmasia dolens is developed. Once in a long 
time, this inflammation of the veins causes so much morbid irrita-. 
tion that abscesses are formed, in the groin first, and then at other 
points, which eventually result in death. This grave form of the 
disease we have never seen, and it will very seldom be found when a 
proper course of treatment is pursued after delivery, by diet and 
medicine. 

Toward the close of the disease, there is afi'usion of water in the 
limb, which is known by the sinking of the finger when pressed on 
the lower part of the limb. This oedema, this swelling, may extend 
to the other lower extremity, or even over the system, though in a 
much less degree. 

Treatment. — It will be found, in almost every instance of this af- 
fection, that for several days before intense pain is established in 
the groin, there is fullness of the abdomen low down on the side, 
"which is to be the seat of the disease. This, we think, is first 



620 AMEHICAN HOUSEHOLD BOOK OF MEDICINE. 

brought about bj costiveness and improper diet, which condition 
of the bowels should be at once attended to. The patient ought 
to take from five to eight grains of calomel, with half a grain of 
opium, which should be followed bv a free dose of castor-oil, Ep- 
som salts, or some other purgative. An ounce of castor-oil, or of 
salts, may be taken, every few hours, until free purging takes 
place. If the purgative does not act within a few hours, injections 
of salt and water ought to be given, every two hours, until the 
medicine acts freely. Now, this course was first suggested to the 
writer by observing that the milk leg nearly always occurs by neg- 
lect in not keeping the bowels sufiici^ntly open after delivery; for, 
when the patient is careful to keep the bowels in an open state, 
and is careful as to diet, and proper regulations as to cleanliness 
and ventilation, the affection seldom occurs. This first premoni- 
tory symptom has not been noticed by writers, yet we think they 
have not been careful enough in observation. We must now con- 
fine ourselves to the treatment after the location in the groin, 
where, no doubt, the disease is in its incipient condition when the 
first uneasiness is felt above. 

When the milk leg has once got established in the groin, and 
there is tenderness, pain, and swelling, it becomes necessary to 
use the most energetic means for subduing inflammation. If the 
patient has a strong pulse, with a hot and dry skin, blood ought 
to be drawn from the arm to the point of fainting. A poultice, or 
cloths dipped in hot water, or hop water, should be applied to the 
affected part, and renewed every eight hours, for several days. 
These applications would be improved by the addition of a tea- 
spoonful of laudanum for each poultice or fomentation. At the 
same time that this is being done, the patient should have her 
bowels moved once or twice a day, by Epsom salts, or some other 
mild purgative. Half a grain of calomel, with ten grains of jalap, 
will answer a good purpose. The dose may be repeated twice a 
day, should one not answer the purpose ; and should the patient 
be feeble, only an occasional action of the bowels ought to be de- 
sired — that is, once every, or every other day, which may be effected 
by seidlitz powders, or a bottle of the fluid citrate of magnesia. But 
patients laboring under phlegmasia dolens do not often need general 
blood-letting, for where the pulse is quick and frequent, without 
much force, leeches should only be used; these, however, ought 
to be used freely. Twenty-four should be applied at once over the 



PHLEGMASIA DOLENS, OR MILK LEG. 621 

sore and painful part, and reapplied every twenty-four hours, until 
the inflammation has lost its force. Sometimes twelve leeches may be 
enough, and in the strong three dozen may be used. Leeches must 
be used occasionally, not only at the groin, but on the inside of 
the thigh, if there be pain and hardness. There must now be at- 
tention paid to the condition of the general system ; the fever must 
be controlled, and sleep must be brought about by anodynes, and, at 
the same time, the healthy action of the skin and kidneys must be 
effected, if possible. The first of these objects must be brought 
about by the combination of tartar emetic, calomel, and opium, 
in small and repeated doses — about half a grain of opium, with 
half a grain of calomel, and the eighth of a grain of tartar emetic, 
two or three times a day, will be enough. Should this amount of 
calomel make the mouth sore, it must be laid aside, and only a 
small blue pill given, twice a week. The kidneys can be excited to 
normal action by ten grains of niter, three times a day, or by two 
grains of the iodide of potash, in a table-spoonful of syrup, once in 
eight hours. Probably this last will do best to depend on. Dur- 
ing the time that the general treatment is going on, the afi'ected 
limb must be attended to with the greatest care ; it should be kept 
in a horizontal position, or the heel a little raised, with the knee 
slightly bent. It should rest on some soft substance. Cotton 
"wadding or batting answers a most excellent purpose. No em- 
brocations or liniment should be used until the inflammation has 
mostly disappeared; before that, poultices and local vapor baths are 
the best. It is our opinion that cold applications will generally 
do harm, though Professor Wood recommends them. After the 
disease has lasted some weeks, it is usual for the whiteness and 
tension to give way, and the limb to assume a more healthy appear- 
ance. There will then be some dropsical effusion, which may be 
treated with the camphorated oil ; or, if there be soreness about 
the groin or lower down, a narrow and long blister, half the length 
of the thigh, should be applied on the inside, which sometimes does 
much good. Again : it will be proper, when there is much debility, 
to apply a muslin or flannel roller on the limb ; the pressure by it 
should be very gentle and even. Reapplication every day should 
be made. 

If the above course be persevered in until the irritation be sub- 
dued, and then gentle exercise with mild tonics be used, the patient 
"will often get up without lameness or swelling. Probably a grain, 



622 AMERICAN HOUSEHOLD BOOK OF MEDICINE 

or a grain and a half of quinine, taken three times a day, will an- 
swer better than any other tonic; or small doses of iron will often 
be useful. Five grains of the carbonate of iron, taken in syrup, 
will answer as well as any preparation. It is sometimes right to 
let the patient take a little wine or brandy after each meal. It 
should never be forgotten that after the force of the disease has 
been expended, opiates should be discontinued ; for, however use- 
ful they are to produce sleep during the acute stage of the malady, 
they become hurtful during the convalescence. 

Ulcees About the Nails. 

These are very common and extremely troublesome, occurring 
usually by the side of the great toe. They are popularly termed 
*' growth of the nail into the flesh." They do not, however, 
arise from any alteration in the nail, as the name would imply, 
but the adjoining soft parts are first swelled and inflamed by con- 
stant pressure against the edge, from the use of tight shoes. If 
this state be permitted to increase, suppuration follows, and then 
an ulcer of extreme sensitiveness is formed. In this the nail be- 
comes imbedded, often producing great pain, so much so as to 
prevent the suff'erer from walking at all. 

Treatment. — We must remove the irritation produced by the 
nail, and reduce the swelling of the soft parts. In most cases, if 
the nail, having been well softened by soaking in warm water, is 
shaved as thin as possible with a bit of glass, the pain and irrita- 
tion may be allayed by rest for a day or two, with fomentations 
and poultices ; and then any ulcer that has formed will soon heal 
with the aid of the following : 

Black Wash. 

No. 242. Calomel 1 drachm. 

Lime water 4 ounces. 

Mix well. 

This wash to be appUed on lint, or we may touch the ulcer with 
lunar caustic. More obstinate cases will require the service of a 
surgeon. 

Felon, or Whitlow. 

This is a very common and painful abscess of the fingers. There 
are four kinds. The first, called cutaneous, is an inflammation of 



TRICHINA SPIRALIS. 623 

the surface of the skin on the end of the finger, accompanied with 
burning pain, and an effusion of watery or bloody fluid, raising the 
skin in the form of a bladder. The second, termed subcutaneous, 
is attended with greater pain and throbbing, and formation of mat- 
ter under the skin at the root of the nail, which may come off. The, 
third, called the tendinous, is an affection of the tendinous sheath, 
or covering immediately next the bone, and called the periosteum. 
This form of felon is the one which usually attracts most atten- 
tion, being, in addition to its extreme painfulness, a very lingering 
complaint. The tendinous sheath of the bone is very tough, and 
will resist suppuration for a long time. The fourth kind, called 
carbuncular, is rarely met with. It partakes of the nature of a 
carbuncle, and is treated similarly. 

Treatment — of the first and second kinds of felon is purgatives, 
followed by tonics, with fomentations and poultices to the affected 
parts. But if these measures do not easily cause the resolution of the 
matter, a pretty free incision should be made into the inflamed 
part. If the tip of the finger is painful and tender for a long time, 
without suppuration, let it be penciled with lunar caustic. 

In treating the tendinous felon, if purgatives and fomentations 
do not speedily relieve, the finger should be laid open by a surgeon. 

Trichina Spiralis. 

Man has ever dreaded the " worms " which fatten on the human 
corpse after death. Totally ignorant are mankind, in general, of 
the insidious "worms" and "parasites" that find their way into 
the living body. There are a variety of species of these worms, 
or parasites, infesting the entire body, leaving scarcely any portion 
untouched. We will not here stop to give a full treatise on all 
these various kinds, but will proceed directly to a consideration of 
the Trichina Spiralis. 

This has proven a more deadly foe to man than all other para- 
sites combined. 

It is discernable only by means of the microscope, and is, in this 
respect, in striking contrast with the tapeworm, which is to be 
found of many feet in length. 

This worm was discovered in the year 1832, and in 1835, Pro- 
fessor Owen published a scientific description of it. The name, 
" Trichina Spiralis," is derived from the strong resemblance which 



624 AMETIICAN HOUSEHOLD BOOK OF MEDICINE. 

the parasite bears to a fine hair, coiled up like a watch-spring. Six 
victims of trichina were reported in London in 1835, creating some- 
what of a stir in the medical profession, since which time several 
cases have been carefully studied, and some light thrown upon 
the subject. We have said that the aid of the magnifying glass is 
necessary in these studies, but when the parasite is inclosed in its 
chalky capsule, or shell, it can frequently be observed with the 
naked eye, appearing as a small white point, when a section of 
muscle is examined. 

We are largely indebted to several eminent German physicians 
for our information concerning trichina spiralis, they having de- 
voted much time to the examination into the nature, structure, and 
habits of this singular pest. 

Many experiments with animals have been made, all going to 
show the destructive power of these worms. By introducing the 
worm into the stomach of the dog, cat, rabbit, fowl, etc., the experi- 
menter was enabled to witness all the various phenomena of trichina 
disease. Seven dogs out of nine thus treated died, and an examina- 
tion of their muscles, after death, disclosed the presence of innu- 
merable free trichinae. 

The parasite gets into the human stomach while yet in its shell. 
This shell is very soon dissolved by the juices of the stomach, set- 
ting free the trichinse, which immediately grow very fast, and are 
ready to bring forth their young in a few days, each female bring- 
ing forth about one hundred live young. This new swarm of 
trichinae begins immediately to burrow through the stomach and 
bowels, their destination being the muscular system of the body, 
avoiding, with singular instinct, the parts usually denominated 
"vital," as the brain, heart, lungs, and liver. The immediate 
effect of this burrowing of the worms in the stomach and bowels, 
is to produce symptoms of diarrhea and dysentery, accompanied 
with bloody discharges from the bowels. The inflammation pro- 
duced is frequently followed by ulceration of the bowels, when 
death rapidly ensues. 

We can not impart a more accurate idea of the terrible ravages 
of trichinae than by presenting the following account, taken from 
a British medical journal : 

"• The village of Hettstadt is situated near the Hartz Mountains, 
in Germany. An annual festival was celebrated there some tvro 
years since, and one hundred and three persons sat down to din- 



TRICHINA SPIRALIS. ^ 625 

ner, the third course consisting of rostewursfe and gemuse (sausage 
and vegetables). The sausage had been prepared beforehand for 
this special occasion. The steward who had been commissioned 
to furnish the pig for this purpose, gave the butcher a lean, ill- 
conditioned one, instead of the thrifty one which had been bar- 
gained for. The day after the festival, several persons who had 
participated in the dinner were attacked with pain and irritation 
of the intestines, with loss of appetite, fever, and great prostration.' 
The number increased from day to day, and an epidemic of ty- 
phus or septic fever was apprehended, as the symptoms began to 
assume that character. However, as the disease progressed, the 
symptoms assumed a different type, and to diarrhea, dysentery, 
and fever were added peritonitis, circumscribed pneumonia, and 
paralysis of the abdominal and intercostal muscles with those of 
the neck. Then the typhus theory was abandoned, and some un- 
known poison was assumed to be at the bottom of it. Under this 
conviction, every, article of food, and material used in connection 
with the dinner, was rigidly examined. By this time, the trichinae 
had reached the muscles of the calf of the leg in some of the vic- 
tims, and Zenker's description of the disease was called to mind. 
The remnants of the sausage were examined, and found to be lit- 
erally swarming with trichinae. Portions of muscle from the calf 
of the leg of the affected ones were examined under the micro- 
scope, and were found full of free trichinae. These were the 
progeny of the encapsuUd ones, which had escaped the smoking 
and frying process to which the sausage had been subjected. No 
less than eighty-three of the above-mentioned number died within 
a few weeks, and the surviving twenty, at last accounts, w^ere still 
lingering in agony, and apprehensive of a similar fate. This awful 
catastrophe at Hettstadt awakened sympathy and fear throughout 
all Germany, and many eminent medical men were consulted in 
the interest of the sufferers, but none could bring relief or cure. 
With an obstinacy unsurpassed by any other disease, trichianisis 
surely carried its victims to the grave. Many vermifuges were em- 
ployed with the hope of removing the parasites still in the alimen- 
tary canal. Picric acid was employed, until its effects seemed as 
dangerous as the disease itself. An examination of the bodies 
after death, showed the trichinae to have been unaffected by any 
of the remedies employed. 

" Professor Mossier, of Germany, has recently made public the 
40 



626 AMERICAN HOUSEHOLD BOOK OF MEDICINE. . 

most successful treatment of this disease. The following is the 
formula : 

No. 243. Benzine 1 scruple. 

Sol. liquorice Muc. Ac. aa 1 oz. 

Aqua Menth 4 oz. 

Mix. 

Of which compound, give a table-spoonful every hour or two." 

In our country, there have been some cases of trichina disease. 
In New York City, early in 1864, a whole family was poisoned by 
eating trichinous pork. The father died ; the rest recovered. A 
man and his wife living in Chicktonago, New York, were fatally 
poisoned by eating diseased pork; and from various parts of the 
country, reports are constantly coming in of new and frequently fatal 
cases of trichina poisoning. The means of detecting the presence 
of these parasites is by the aid of the microscope, which is quite 
out of the question with the public at large. That portion of our 
community denominated Israelites will undoubtedly escape the dis- 
ease altogether. 



HOW TO NUESE THE SICK. 627 



CHAPTER IX. 

HOW TO NURSE THE SICK. 

It has been said that every woman makes a good nurse. I be- 
lieve, on the contrary, that the very elements of nursing are all but 
unknown. 

By this I do not mean that the nurse is always to blame. Bad 
sanitary, bad architectural, and bad administrative arrangements 
often make it impossible to nurse. But the art of nursing ought 
to include such arrangements as alone make what I understand by 
nursing possible. 

The art of nursing, as now practiced, seems to be expressly con- 
stituted to unmake what God had made disease to be, viz., a re- 
parative process. 

In many diseases, the exact value of particular remedies and 
modes of treatment is by no means ascertained, while there is uni- 
versal experience as to the extreme importance of careful nursing 
in determining the issue of the disease. 

The very elements of what constitutes good nursing are as little 
understood for the well as for the sick. The same laws of health 
or of nursing, for they are in reality the same, obtain among the 
well as among the sick. The breaking of them produces only a 
less violent consequence among the former than among the latter — 
and this sometimes, not always. 

It is constantly objected, " But how can I obtain this medical 
knowledge ? I am not a doctor. I must leave this to doctors." 

Oh, mothers of families ! You who say this do you know that 
one in every seven infants perishes before it is one year old? Is 
all this premature suffering and death necessary? Or did Nature 
intend mothers to be always accompanied by doctors ? Or is it better 
to learn the piano-forte than to learn the laws which subserve the 
preservation of offspring ? 

The very first rule of nursing, the first and the last thing upon 



628 • AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

"wMch a nurse's attention must be fixed, the first essential to a pa- 
tient, without which all the rest you can do for him is as nothing, 
with which, I had almost said, you may leave all the rest alone, is 
this : To keep the air he breathes as pure as the external air, 
WITHOUT CHILLING HIM. Yet what is so little attended to? Even 
where it is thought of at all, the most extraordinary misconceptions 
reign about it. Even in admitting air into the patient's room or 
ward, few people ever think where that air comes from. It may 
coine from a corridor into which other wards are ventilated ; from 
a hall, always unaired, always full of the fames of gas, dinner, of 
various kinds of mustiness; from an underground kitchen, sink, 
wash-house, water-closet, or even, as I myself have had sorrowful 
experience, from open sewers loaded with filth; and with this the 
patient's room or ward is aired, as it is called — poisoned, it should 
rather be said. Always air from the air without, and that, too, 
throuo;h those windows throuo;h which the air comes freshest. From 
a closed court, especially if the wind do not blow that way, air 
may come as stagnant as any from a hall or corridor. 

Again, a thing I have often seen both in private houses and in- 
stitutions. A room remains uninhabited; the fire-place is care- 
fully fastened up with a board, the windows are never opened; 
probably the shutters are kept always shut ; perhaps some kind of 
stores are kept in the. room; no breath of fresh air can by possi- 
bility enter into that room, nor any ray of sun. The air is as stag- 
nant, musty, and corrupt as it can by possibility be made. It is 
quite ripe to breed small-pox, scarlet fever, diphtheria, or any 
thing else you please. 

Yet the nursery, ward, or sick room adjoining will positively be 
aired (?) by having the door opened into that room. Or children 
will be put into that room, without previous preparation, to sleep. 

With a proper supply of windows, and a proper supply of fuel in 
open fire-places, fresh air is comparatively easy to secure when 
your patient or patients are in bed. Never be afraid of open win- 
dows then. People don't catch cold in bed. With proper bed- 
clothes and hot bottles, if necessary, you can always keep a patient 
warm in bed, and well ventilate him at the same time. 

But a careless nurse will stop up every cranny, and keep a hot- 
house heat when her patient is in bed; and, if he is able to get up, 
leave him comparatively unprotected. The time when people take 
cold (and there are many ways of taking cold besides a cold in the 



HOW TO NURSE THE SICK. 629 

nose), is when they first get up after the twofold exhaustion of 
dressing and of having had the skin relaxed by many hours, per- 
haps days, in bed, and thereby rendered more incapable of reaction. 
Then the same temperature which refreshes the patient in bed, may 
destroy the patient just risen. And common sense will point ou* 
that, while purity of air is essential, a temperature must be secured 
which shall not chill the patient. Otherwise, the best that can be 
expected will be a feverish reaction. 

To have the air within as pure as the air without, it is not neces- 
sary, as often appears to be thought, to make it as cold. 

In the afternoon, again, without care, the patient, whose vital 
powers have then risen, often finds the room as close and oppress- 
ive as he found it cold in the morning. Yet the nurse will be 
terrified if a window is opened. 

In a little book on nursing, published a short time ago, we are 
told that, " with proper care it is very seldom that the windows 
can not be opened for a few minutes twice a day, to admit fresh air 
from without." I should think not ; nor twice in an hour either. 
It only shows how little the subject has been considered. 

Of all methods of keeping patients warm, the very worst cer- 
tainly is to depend for heat on the breath and bodies of the sick. 
I have known a medical officer keep his ward windows hermetically 
closed. Thus exposing the sick to all the dangers of an infected 
atmosphere, because he was afraid that, by admitting fresh air, the 
temperature of the ward would be too much lowered. This is a 
destructive fallacy. 

To attempt to keep a ward warm at the expense of making the 
sick repeatedly breathe their own hot, humid, putrescing atmos- 
phere is a certain way to delay recovery, or to destroy life. 

Do you ever go into the bed-rooms of any persons of any class, 
whether they contain one, two, or twenty people, whether they 
hold sick or well, at night, or before the windows are opened in 
the morning, and ever find the air any thing but un wholesomely 
close and foul ? And why should it be so ? And of how much 
importance it is that it should not be so? During sleep, the 
human body, even when in health, is far more injured by the influ- 
ence of foul air than when awake. Why can't you keep the air 
all night, then, as pure as the air without, in the rooms you sleep 
in ? But for this, you must have sufficient outlet for the impure 
air you make yourselves to go out; sufficient inlet for the pure 



630 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

air from without to come in. You must have open chimneys, open 
windows, or ventilators ; no close curtains round your beds ; no 
shutters or curtains to your windows, none of the contrivances by 
which you undermine your own health, or destroy the chances of 
recovery of your sick. 

A careful nurse will keep a constant watch over her sick, espe- 
cially weak, protracted, and collapsed cases, to guard against the 
effects of the loss of vital heat by the patient himself. In cer- 
tain diseased states much less heat is produced than in health ; 
and there is a constant tendency to the decline and ultimate ex- 
tinction of the vital powers by the call made upon them to sus- 
tain the heat of the body. Cases where this occurs should be 
watched with the greatest care from hour to hour, I had almost 
said from minute to minute. The feet and legs should be ex- 
amined by the hand, from time to time, and whenever a tendency 
to chilling is discovered, hot bottles, hot bricks, or warm flannels, 
with some warm drink, should be made use of until the tempera- 
ture is restored. The fire should be, if necessary, replenished. 
Patients are frequently lost in the latter stages of disease from 
want of attention to such simple precautions. The nurse may be 
trusting to the patient's diet, or to his medicine, or to the occa- 
sional dose of stimulant which she is directed to give him, while 
the patient is all the while sinking from want of a little external 
warmth. Such cases happen at all times, even during the height 
of summer. This fatal chill is most apt to occur toward early 
morning at the period of the lowest temperature of the twenty- 
four hours, and at the time when the effect of the preceding day's 
diets is exhausted. 

Generally speaking, you may expect that weak patients will suf- 
fer cold much more in the morning than in the evening. The 
vital powers are much lower. If they are feverish at night, with 
burning hands and feet, they are almost sure to be chilly and 
shivering in the morning. But nurses are very fond of heating 
the foot-warmer at night, and of neglecting it in the morning, 
when they are busy. I should reverse the matter. 

All these things require common sense and care. Yet, perhaps, 
in no one single thing is there so little common sense shown, in 
all ranks, as in nursing. 

The extraordinary confusion between cold and ventilation, even 
in the minds of well-educated people, illustrates this. To make 



HOW TO NURSE THE SICK. 631 

a room cold is by no means necessarily to ventilate it. Nor is it 
at all necessary, in order to ventilate a room, to chill it. Yet, 
if a nurse finds a room close, she will let out the fire, thereby 
making it closer, or she will open the door into a cold room, with- 
out a fire, or an open window in it, by way of improving the ven- 
tilation. The safest atmosphere of all for a patient is a good fire 
and an open window, excepting in extremes of* temperature. To 
ventilate a small room without draughts, of course requires more 
care than to ventilate a large one. 

Always air your room from the outside air, if possible. Win- 
dows are made to open ; doors are made to shut — a truth which 
seems extremely difficult of apprehension. 

If we are to preserve the air within as pure as the air without, 
it is needless to say that the chimney must not smoke. Almost 
all smoky chimneys can be cured — from the bottom, not from the 
top. Often it is only necessary to have an inlet for air to supply 
the fire, which is feeding itself, for want of this, from its own 
chimney. On the other hand, almost all chimneys can be made 
to smoke by a careless nurse, who lets the fire get low, and then 
overwhelms it with coal; not, as we verily believe, in order to 
spfire herself trouble (for very rare is unkindness to the sick), but 
from not thinking what she is about. 

In laying down the principle that the first object of the nurse 
must be to keep the air breathed by her patient as pure as the air 
without, it must not be forgotten that every thing in the room 
which can give off effluvia, besides the patient, evaporates itself 
into his air. And it follows that there ought to be nothing in the 
room, excepting him, which can give off effluvia or moisture. Out 
of all damp towels, etc., which become dry in the room, the damp, 
of course, goes into the patient's air. 

Even in health people can not repeatedly breathe air in which 
they live with impunity, on account of its becoming charged with 
unwholesome matter from the lungs and skin. In disease where 
every thing given off from the body is highly noxious and danger- 
ous, not only must there be plenty of ventilation to carry off the 
effluvia, but every thing which the patient passes must be instantly 
removed, as being more noxious than even the emanations from 
the sick. 

Of the fatal effects of the effluvia from the excreta, it would 
seem unnecessary to speak, were they not so constantly neglected. 



632 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Concealing tlie utensils behind tlie vallance to the bed seems all- 
the precaution which is thought necessary for safety in private 
nursing. Did you but think for one moment of the atmosphere 
under that bed, the saturation of the under side of the mattress 
with the warm evaporations, you would be startled, and frightened 
too! 

The use of any chamber utensil ivithout a lid should be utterly 
abolished, whether among sick or well. You can easily convince 
yourself of the necessity of this absolute rule, by taking one with 
a lid, and examining the under side of that lid. It will be found 
always covered, whenever the utensil is not empty, by condensed 
offensive moisture. Where does that go, when there is no lid ? 

Earthenware, or if there is any wood, highly polished and var- 
nished wood, are the only materials fit for patients' utensils. The 
very lid of the old abominable close-stool is enough to breed a 
pestilence. It becomes saturated with' offensive matter, which 
scouring is only wanted to bring out. I prefer an earthenware lid 
as being always cleaner. But there are various good new-fash- 
ioned arrangements. 

A slop-pail should never be brought into a sick room. It should 
be a rule invariable, rather more important in the private houle 
than elsewhere, that the utensil should be carried directly to the 
water-closet, emptied there, rinsed there, and brought back. There 
should always be water and a faucet in every water-closet for rins- 
ing. But even if there is not, you must carry water there to 
rinse with. In the best hospitals it is now a rule that no slop- 
pall shall ever be brought into the wards, but that the utensils 
shall be carried direct to be emptied and rinsed at the proper place. 
I would it were so in the private house. 

Let no one ever depend upon fumigations, " disinfectants," and 
the like, for purifying the air. The offensive thing, not its smell, 
must be removed. A celebrated medical lecturer began, one day, 
" Fumigations, gentlemen, are of essential importance. They make 
such an abominable smell that they compel you to open the win- 
dow." I wish all the disinfecting fluids invented made such an. 
"abominable smell" that they forced you to admit fresh air. 
That would be a useful invention. 

There are five essential points in securing the health of houses : 

1. Pure air. 

2. Pure water. 



HOW TO NURSE THE SICK. 633 

3. Efficient drainage. 

4. Cleanliness. 
, 5. Light. 

Without these, no house can be healthy. And it will be unhealthy 
just in proportion as they are deficient. 

1. To have pure air, your house should be so constructed as 
that the outer atmosphere shall find its way with ease to every 
corner of it. House architects hardly ever consider this. The 
object in building a house is to obtain the largest interest for the 
money, not to save doctors' bills to the tenants. But, if tenants 
should ever become so wise as to refuse to occupy unhealthy con- 
structed houses, and if insurance companies should ever come to 
understand their interest so thoroughly as to pay a Sanitary Sur- 
veyor to look after the houses where their clients live, speculative 
architects w^ould speedily be brought to their senses. As it is, 
they build what pays best. And there are always people foolish 
enough to take the houses they build. And if in the course of 
time the families die off, as is so often the case, nobody ever thinks 
of blaming any but Providence for the result. Badly constructed 
houses do for the healthy what badly constructed hospitals do for 
the sick. Once insure that the air in a house is stagnant, and 
sickness is certain to follow. 

2. Pure water is more generally introduced into houses than it 
used to be. 

3. Many people have no idea in what good drainage consists. 
They think that a sewer in the street, and a pipe leading to it from 
the house, is good drainage. All the while the sewer may be noth- 
ing but a laboratory from which epidemic disease and ill health is 
being distilled into the house. No house with any untrapped drain- 
pipe communicating immediately with a sewer, whether it be from 
water-closet, sink, or gully-gate, can ever be healthy. An un- 
trapped sink may at any time spread fever or pyemia among the 
inmates of a palace. 

Another great evil in house construction is carrying drains un- 
derneath the house. Such drains are never safe. All house drains 
should^begin and end outside the walls. Many people will readily 
admit, as a theory, the importance of these things ; but how few 
are there who can intelligently trace disease in their households to 
such causes ! Is it not a fact, that when scarlet fever, measles, or 
Bmall-pox appear among the children, the very first thought which 



634 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

occurs is, "where" the children can have '^caught" the disease? 
And the parents immediately run over in their minds all the fami- 
lies with whom they may have been. They never think of looking 
at home for the source of the mischief. If a neighbor's child is 
seized with small -pox, the first question which occurs is, whether 
it had been vaccinated. No one would undervalue vaccination; 
but it becomes of doubtful benefit to society when it leads people 
to look abroad for the source of evils which exist at home. 

4. Without cleanliness, within and without your house, ventila- 
^tion is comparatively useless. Rich people like to have their 
stables and dung-hill near their houses. But does it ever occur to 
them that with many arrangements of this kind it would be safer to 
keep the windows shut than open ? You can not have the air of 
the house pure with dung-heaps under the windows. And yet 
people are surprised that their children, brought up in large "well- 
aired" nurseries and bed-rooms, suifer from children's epidemics. 
If they studied Nature's laws in the matter of children's health, 
they would not be so surprised. 

There are other ways of having filth inside a house besides hav- 
ing dirt in heaps. Old papered walls of years' standing, dirty 
carpets, uncleansed furniture, are just as ready sources of impurity 
to the air as if there were a dung-heap in the basement. People 
are so unaccustomed, from education and habits, to consider how to 
make a home healthy, that they either never think of it at all, and 
take every disease as a matter of course, to be "resigned to" 
when it comes " as from the hand of Providence ;" or, if they ever 
entertain the idea of preserving the health of their household as 
a duty, they are very apt to commit all kinds of "negligences and 
ignorances " in performing it. 

5. A dark house is always an unhealthy house, always an ill- 
aired house, always a dirty house. Want of light stops growth, 
and promotes scrofula, rickets, etc., among the children. 

People lose their health in a dark house, and if they get ill, they 
can not get well again in it. 

Three out of many " negligences and ignorances " in managing 
the health of houses generally, I will here mention as specknens : 
1. That the female head in charge of any building does not think 
it necessary to visit every hole and corner of it every day. How 
can she expect those who are under her to be more careful to 
maintain her house in a healthy condition than she who is ia 



HOW TO NURSE THE SICK. 635 

charge of it ? 2. That it is not considered essential to air, to sun, 
and to clean rooms while uninhabited; which is simply ignoring 
the first elementary notion of sanitary things, and laying the 
ground ready for all kinds of diseases. 3. That the window, and 
one windovf, is considered enough to air a room. Have you never, 
observed that any room without a fire-place is always close ? And, 
if you have a fire-place, would you cram it up not only with a 
chimney-board, but perhaps with a great wisp of brown paper, in 
the throat of the chimney — to prevent the soot from coming down, 
you say? If your chimney is foul, sweep it; but don't expect 
that you can ever air a room with only one aperture ; don't sup- 
pose that to shut up a room is the way to keep it clean. It is the 
best way to foul the room and all that is in it. Don't imagine 
that if you, who are in charge, don't look to all these things your- 
self, those under you will be more careful than you are. It ap- 
pears as if the part of a mistress now is to complain of her serv- 
ants, and to accept their excuses — not to show them how there 
need be neither complaints made nor excuses. 

The houses of the grandmothers and great-grandmothers of 
this generation, at least the country-houses, with front door and 
back door alwaj^s standing open, winter and summer, and a thorough 
draft always blowing through — with all the scrubbing, and clean- 
ing, and polishing, and scouring which used to go on, the grand- 
mothers, and still more the great-grandmothers, always out of 
doors, and never with a bonnet on except to go to church, these 
things entirely account for the fact so often seen of a great-grand- 
mother, who was a tower of physical vigor, descending into a 
grandmother perhaps a little less vigorous, but still sound as a bell 
and healthy to the core, into a mother languid and confined to her 
carriage and house, and lastly into a daughter sickly and con- 
fined to her bed. 

With regard to the health of houses where there is a sick per- 
son, it often happens that the sick-room is made a ventilating shaft 
for the rest of the house ; for, while the house is kept as close, 
unaired, and dirty as usual, the window of the sick-room is kept 
a little open always, and the door occasionally. Now, there are 
certain sacrifices which a house with one sick person in it does 
make to that sick person : it ties up its knocker; it lays straw be- 
fore it in the street. Why can't it keep itself thoroughly clean 
and unusually well aired, in deference to the sick person? 



636 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

We must not forget what, in ordinary language, is called "In- 
fection" — a thing of which people are generally so afraid that 
they frequently follow the very practice in regard to it which they 
ought to avoid. Nothing used to be considered so infectious or 
contagious as small-pox; and people not very long ago used to 
cover up patients with heavy bedclothes, while they kept up large 
fires and shut the windows. Small-pox, of course, under this 
regime, is very "infectious." People are somewhat wiser now in 
their managemxcnt of this disease. They have ventured to cover 
the patients Hghtly, and to keep the windows open; and we hear 
much less of the " infection " of small-pox than we used to do. 
But do people in our days act with more wisdom on the subject 
of " infection " in fevers — ^scarlet fever, measles, etc. — than their 
forefathers did with small-pox ? Does not the popular idea of "in- 
fection" involve that people should take greater care of themselves, 
than of the patient ? that, for instance, it is safer not to be too 
much with the patient, not to attend too much to his wants ? 

True nursing ignores infection, except to prevent it. Cleanli- 
ness and fresh air from open windows, with unremitting attention 
to the patient, are the only defense a true nurse either asks or 
needs. 

Wise and humane management of the patient is the best safe- 
guard against infection. 

Unnecessary noise, or noise that creates an expectation in the 
mind, is that which hurts a patient. It is rarely the loudness of 
the noise, the effect upon the organ of the ear itself, which appears 
to affect the sick ; but the talking, or the whispering, especially 
if it be of a familiar voice, outside his door. 

There are certain patients, no doubt, especially where there 
is slight concussion or other disturbance of the brain, who are 
affected by mere noise; but intermittent noise, or sudden and 
sharp noise, in these, as in all other cases, affect far more than 
continuous noise — noise with jar far more than noise without. Of 
one thing you may be certain, that any thing which wakes a patient 
suddenly out of his sleep will invariably put him into a state of 
greater excitement, do him more serious, aye, and lasting mischief, 
than any continuous noise, however loud. 

Never allow a patient to be waked, intentionally or accident- 
ally. If he is roused out of his first sleep, he is almost certain to 
have no more sleep. It is a curious but quite intelligible fact, that 



HOW TO NURSE THE SICK. 637 

if a patient is waked after a few hours-' instead of a few minutes' 
sleep, he is much more likely to sleep again; because pain, like 
irritability of brain, perpetuates and intensifies itself. If you 
have gained a respite of either in sleep, you have gained more 
than the mere respite. Both the probability of recurrence and o£ 
the same intensity will be diminished; whereas both will be terri- 
bl}^ increased by want of sleep. This is the reason why sleep is 
so all-important. This is the reason why a patient waked in the 
early part of his sleep loses not only his sleep, but his power to 
sleep. A healthy person who allows himself to sleep during the 
day will lose his sleep at night. But it is exactly the reverse with 
the sick generally; the more they sleep, the better will they be 
able to sleep. 

I have often been surprised at the thoughtlessness of friends 
who will hold a long conversation just in the room or passage ad- 
joining to the room of the patient, who is either every moment ex- 
pecting them to come in, or who has just seen them, and knows 
they are talking about him. If he is an amiable patient, he will 
try to occupy his attention elsewhere, and not to listen; and this 
makes matters worse, for the strain upon his attention and the 
effort he makes are so great that it is well if he is not worse for 
hours after. If it is a whispered conversation, in the same room, 
then it is absolutely cruel; for it is impossible that the patient's 
attention should not be involuntarily strained to hear. Walking 
on tiptoe, doing any thing in the room very slowly, are injurious, 
for exactly the same reasons. A firm, light, quick step, a steady, 
quick hand, are desirable ; not the slow, lingering, shuffling foot, the 
timid, uncertain touch. 

Unnecessary (although slight) noise injures a sick person much 
more than necessary noise (of a much greater amount). 

The fidget of silk and of crinoline, the rattling of keys, the 
creaking of stays and of shoes, will do a patient more harm than 
all the medicines in the world will do him good. 

Again, one nurse can not open the door without making every 
thing rattle ; or she opens the door unnecessarily often, for want 
of remembering all the articles that might be brought in at 
once. 

A good nurse will always make sure that no door or window in 
her patient's room shall rattle or creak ; that no blind or curtain 
shall, by any change of wind through the open window, be made 



638 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

to flap ; especially will she be careful of all this before she leaves 
her patients for the night. 

Always sit within the patient's view, so that when you speak to 
him he has not painfully to turn his head round in order to look 
at you. Everybody involuntarily looks at the person speaking. 
If you make this act a wearisome one on the part of the patient 
you are doing him harm. So, also, if by continuing to stand you 
make him continuously raise his eyes to see you. Be as motionless 
as possible, and never gesticulate in speaking to the sick. 

If the invalid is forced, by his avocations, to continue occupa- 
tions requiring much thinking, the injury is doubly great. In 
feeding a patient suffering under delirium or stupor, you may suf- 
focate him, by giving him his food suddenly, but if you rub his 
lips gently with a spoon, and thus attract his attention, he will 
swallow the food unconsciously, but with perfect safety. Thus it 
is with the brain. If you offer it a thought, especially one requir- 
ing a decision abruptly, you do it a real not fanciful injury. 
Never speak to a sick person suddenly ; but, at the same time, do 
not keep his expectation on the tiptoe. 

Do not meet or overtake a patient who is moving about in order 
to speak to him, or to give him any message or letter. You might 
just as well give him a box on the ear. I have seen a patient fall 
flat on the ground who was standing when his nurse came into 
the room. This was an accident which might have happened to 
the most careful nurse. But the other is done with intention. A 
patient in such a state is not going to the East Indies. If you 
would wait ten seconds, or walk ten yards further, any promenade 
he could make would be over. You do not know the effort it is 
to a patient to remain standing for even a quarter of a minute 
to listen to you. If I had not seen the thing done by the kindest 
nurses and friends, I should have thought this caution quite super- 
fluous. 

Patients are often accused of being able to " do much more 
when nobody is by." It is quite true that they can. Unless 
nurses can be brought to attend to considerations of the kind of 
which we have given here but few specimens, a very weak patient 
finds it really much less exertion to do things for himself than to 
ask for them. And he will, in order to do them, (very innocently 
and from instinct) calculate the time his nurse is likely to be 
absent, from a fear of her '* coming in upon " him or speaking to 



HOW TO NURSE THE SICK. 639 

him, just at the moment when he finds it quite as much as he can 
do to crawl from his bed to his chair, or from one room to another, 
or down stairs, or out of doors for a few minutes. Some extra 
call made upon his attention at that moment will quite upset him. 
In these cases you may be sure that a patient in the state we have 
described does not make such exertions more than once or twice 
a day, and probably much about the same hour every day. And 
it is hard, indeed, if nurse and friends can not calculate so as to let 
him make them undisturbed. Remember, that many patients can 
walk who can not stand or even sit up. Standing is, of all posi- 
tions, the most trying to a weak patient. 

Every thing you do in a patient's room, after he is "put up " 
for the night, increases tenfold the risk of his having a bad night. 
But, if you rouse him up after he has fallen asleep, you do not 
risk, you secure himi a bad night. 

One hint I would give to all who attend or visit the sick, to all 
who have to pronounce an opinion upon sickness or its progress. 
Come back and look at your patient after he has had an hour's 
animated conversation with you. It is the best test of his real 
state we know. But never pronounce upon him from merely see- 
ing what he does, or how he looks, during such a conversation. 
Learn also carefully and exactly, if you can, how he passed the 
night after it. 

People rarely, if ever, faint while making an exertion. It is 
after it is over. Indeed, almost every effect of over-exertion 
appears after, not during such exertion. It is the highest folly 
to judge of the sick, as is so often done, when you see them 
merely during a period of excitement. People have very often 
died of that which, it has been proclaimed at the time, has " done 
them no harm." 

Remember never to lean against, sit upon, or unnecessarily 
shake, or even touch the bed in which a patient lies. This is in- 
variably a painful annoyance. If you shake the chair on which 
he sits, he has a point by which to steady himself, in his feet; 
but on a bed or sofa, he is entirely at your mercy, and he feels 
every jar you give him all through him. 

With regard to reading aloud in the sick room, my experience is, 
that when the sick are too ill to read to themselves, they can sel- 
dom bear to be read to. Children, eye-patients, and uneducated 
persons are exceptions, or where there is any mechanical difficulty 



640 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

in reading. People who like to be read to, have generally not 
much tbe matter with them ; while in fevers, or where there is 
much irritability of brain, the effort of listening to reading aloud 
has often brought on delirium. 

One thing more : From the flimsy manner in which most mod- 
ern houses are built, where every step on the stairs, and along the 
floors, is felt all over the house, the higher the story, the greater 
the vibration. It is inconceivable how much the sick sufi'er by 
having any body overhead. In the solidly-built old houses, which, 
fortunately, most hospitals are, the noise and shaking is compara- 
tively trifling; but it is a serious cause of suff"ering, in lightly- 
built houses, and with the irritability peculiar to some diseases. 
Better far put such patients at the top of the house, even with the 
additional fatigue of stairs, if you can not secure the room above 
them being untenanted ; you may otherwise bring on a state of 
restlessness which no opium will subdue. Do not neglect the warn- 
ing, Avhen a patient tells you that he " feels every step above him 
to cross his heart." Remember that every noise a patient can not 
see partakes of the character of suddenness to him ; and I am per- 
suaded that patients with these peculiarly irritable nerves are pos- 
itively less injured by having persons in the same room with them 
than overhead, or separated only by a thin compartment. Any 
sacrifice to secure silence for these cases is worth while, because 
no air, however good, no attendance, however careful, will do any 
thing for such cases without quiet. 

To any but an old nurse, or an old patient, the degree would be 
quite inconceivable to which the nerves of the sick sufi'er from see- 
ing the same walls, the same ceihng, the same surroundings, during 
a long confinement to one or two rooms. 

The superior cheerfulness of persons sufi'ering severe paroxysms 
of pain, over that of persons sufi'ering from nervous debility, has 
often been remarked upon, and attributed to the enjoyment of the 
former of their intervals of respite. I incline to think that the ma- 
jority of cheerful cases is to be found among those patients who 
are not confined to one room, whatever their sufi'ering, and that the 
majority of depressed cases will be seen among those subjected to 
a long monotony of objects about them. 

The efi'ect in sickness of beautiful objects, of variety of objects, 
and especially of brilliancy of color, is hardly at all appreciated.- 

People say the efi'ect is only on the mind. It is no such thing. 



HOW TO NURSE THE SICK. 641 

The effect is on the body too. Little as we know about the way 
in which we are affected by form, by color, and light, we do know 
this, that they have an actual physical effect. 

Variety of form and brilliancy of color in the objects presented 
to patients are actual means of recovery. 

But it must be slow variety : if you show a patient ten or twelve 
engravings successively, ten to one that he does not become cold 
and faint, or feverish, or even sick ; but hang one up opposite him, 
one on each successive day, or week, or month, and he will revel 
in the variety. 

Volumes are now written and spoken upon the effect of the mind 
upon the body. Much of it is true. But I wish a little more was 
thought of the effect of the body on the mind. 

A patient can just as much move his leg when it is fractured as 
change his thoughts when no external help from variety is given 
him. This is, indeed, one of the main sufferings of sickness, just 
as the fixed posture is one of the main sufferings of the brokea 
limb. 

Every careful observer of the sick will agree in this, that thou- 
sands of patients are annually starved, in the midst of plenty, 
from want of attention to the ways which alone make it possible 
for them to take food. This want of attention is as remarkable 
in those who urge upon the sick to do what is quite impossible to 
them, as in the sick themselves who will not make the effort to do 
what is perfectly possible to them. 

For instance, to the large majority of very weak patients it is 
quite impossible to take any solid food before 11 A. M. ; nor then, 
if their strength is still further exhausted b}" fasting till that hour. 
For weak patients have generally feverish nights, and, in the 
morning, dry mouths ; and, if they could eat with those dry 
mouths, it would be the worse for them. A spoonful of beef-tea, 
of arrowroot and wine, of egg flip, every hour, will give them the 
requisite nourishment, and prevent them from being too much 
exhausted to take at a later hour the solid food which is neces- 
sary for their recovery. And every patient who can swallow at 
all can swallow these liquid things, if he chooses. 

Again, a nurse is ordered to give a patient a tea-cupful of 
some article of food every three hours. The patient's stomach 
rejects it. If so, try a table-spoonful every hour; if this will 
not do, a tea-spoonful every quarter of an hour. 



642 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

I am bound to say, that I think more patients are lost by "want 
of care and ingenuity in these momentous minutiae in private nurs- 
ing than in public hospitals. 

In very weak patients there is often a nervous difficulty of swal- 
lowing, which is so much increased by any other call upon their 
strength, that unless they have their food punctually at the minute, 
which minute again must be arranged so as to fall in with no other 
minute's occupation, they can take nothing until the next respite 
occurs, so that an unpunctuality or delay of ten minutes may very 
well turn out to be one of two or three hours. And why is it not 
as 'easy to be punctual to a minute ? Life often literally hangs 
upon these minutes. 

In acute cases, where life or death is to be determined in a few 
hours, these matters are very generally attended to, especially in 
hospitals ; and the number of cases is large where the patient is, 
as it were, brought back to life by exceeding care on the part of 
the doctor or nurse, or both, in ordering and giving nourishment 
with minute selection and punctuality. 

But in chronic cases, lasting over months and years, where the 
fatal issue is often determined at last by mere protracted starva- 
tion, I had rather not enumerate the instances which I have known 
where a little ingenuity, and a great deal of perseverance, might, 
in all probability, have averted the result. The consulting the 
hours when a patient can take food, the observation of the times, 
often varying, when he is most faint, the altering seasons of 
taking food, in order to anticipate and prevent such times — ^all 
this, which requires observation, ingenuity, and perseverance (and 
these really constitute the good nurse), might save more lives than 
we wot of. 

To leave the patient's untasted food by his side, from meal to 
meal, in hopes that he will eat it in the interval, is simply to pre- 
vent him from taking any food at all. I have known patients 
literally incapacitated from taking one article of food after an- 
other, by this piece of ignorance. Let the food come at the right 
time, and be taken away, eaten or uneaten, at the right time ; 
but never let a patient have "something always standing" by 
him, if you don't wish to disgust him of every thing. 

A patient should, if possible, not see or smell either the food 
of others, or a greater amount of food than he himself can con- 
sume at one time, or even hear food talked about, or see it in the 



HOW TO NURSE THE SICK. 643 

raw state. I know of no exception to the above rule. The 
breaking of it always induces a greater or less incapacity of 
taking food. 

That the more alone an invalid can be when taking food, the 
better, is unquestionable ; and, even if he must be fed, the nurse 
should not allow him to talk, or talk to him, especially about food, 
while eating. 

A nurse should never put before a patient milk that is sour, 
meat or soup that is turned, an egg that is bad, or vegetables 
underdone. Yet often I have seen these things brought in to the 
sick in a state perfectly perceptible to every nose or eye except 
the nurse's. 

If the nurse is an intelligent being, and not a mere carrier of 
diets to and from the patient, let her exercise her intelligence in 
these things. How often we have known a patient eat nothing 
at all in the day, because one meal was left untasted (at that 
time he was incapable of eating), at another the milk was sour, 
the third was spoiled by some other accident. And it never 
occurred to the nurse to extemporize some expedient — ^it never 
occurred to her that as he had had no solid food that day he 
might eat a bit of toast (say) with his tea in the evening, or he 
might have some meal an hour earlier. A patient who can not 
touch his dinner at two, will often accept it gladly if brought to 
him at seven. 

I would say to the nurse, have a rule of thought about your 
patient's diet; consider, remember how much he has had, and 
how much he ought to have to-day. If he is used to having his 
stimulus at one hour to-day, and to-morrow he does not have it, 
because she has failed in getting it, he will suffer. She must be 
always exercising her ingenuity to supply defects, and to remedy 
accidents. 

One very minute caution — take care not to spill into your pa- 
tient's saucer; in other words, take care that the outside bottom 
rim of his cup shall be quite dry and clean ; if, every time he lifts his 
cup to his lips, he has to carry the saucer with it, or else to drop the 
liquid upon and to soil his sheet, or his bed-gown or pillow, or if 
he is sitting up, his dress, you have no idea what a difference this 
minute want of care on your part makes to his comfort and even 
to his wilHngness for food. 

There are some common errors among women in charge of sick 



644 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

respecting sick diet. One is the belief that beef tea is the most 
nutritive of all articles. Now, just try and boil down a pound of beef 
into beef tea, evaporate your beef tea, and see -what is left of your 
beef. You will find that there is barely a tea-spoonful of solid 
nourishment to half a pint of water in beef tea ; nevertheless, there 
is a certain reparative quality in it, we do not know what, as there 
is in tea ; but it may safely be given in almost any inflammatory 
disease, and is as little to be depended upon with the healthy or 
convalescent where much nourishment is required. Again, it is 
an ever ready saw that an egg is equivalent to a pound of meat, 
whereas it is not at 'all so. Also, it is seldom noticed with how 
many patients, particularly of nervous or bilious temperament, 
eggs disagree. All puddings made with eggs are distasteful to 
them in consequence. An egg, whipped up with wine, is often the 
only form in which they can take this kind of nourishment. Again : 
if the patient has attained to eating meat, it is supposed that to 
give him meat is the only thing needful for his recovery; whereas 
scorbutic sores have been actually known to appear among sick 
persons which could be traced to no other source than this, viz. : 
that the nurse, depending on meat alone, had allowed the patient 
to be without vegetables for a considerable time, these latter being 
so badly cooked that he always left them untouched. 

Again : milk and the preparations from milk are a most impor- 
tant article of food for the sick. Butter is the lightest kind of 
animal fat, and, though it wants the sugar and some of the other 
elements which there are in milk, yet it is most valuable both in 
itself and in enabling the patient to eat more bread. Cream, in 
many long chronic diseases, is quite irreplaceable by any other 
article whatever. It seems to act in the same manner as beef tea, 
and to most it is much easier of digestion than milk. In fact, it 
seldom disagrees. Cheese is not usually digestible by the sick, 
but it is pure nourishment for repairing waste; and I have seen 
sick, and not a few either, whose craving for cheese showed how 
much it was needed by them. 

But, if fresh milk is so valuable a food for the sick, the least 
change or sourness in it makes it of all articles, perhaps, the most 
injurious ; diarrhea is a common result of fresh milk allowed to 
become at all sour. Buttermilk, a totally diff'erent thing, is often 
very useful, especially in fevers. 

In laying down rules of diet by the amounts of " solid nutri- 



HOW TO NURSE THE SICK. 645^ 

ment " in different kinds of food, it is constantly lost sight of what' 
the patient requires to repair his waste — what he can take and what 
he can not. You can not diet a patient from a book ; you can not 
make up the human body as you would make up a prescription-— 
so many parts " carboniferous," so many parts " nitrogenous " will 
constitute a perfect diet for the patient. The nurse's observation 
here will materially assist the doctor — the patient's *' fancies " will 
materially assist the nurse. For instance, sugar is one of the 
most nutritive of all articles, being pure carbon, and is particularly 
recommended in some books. But the vast majority of all pa- 
tients, young and old, male and female, rich and poor, hospital and 
private, dislike sweet things ; and, while I have never known a per- 
son take to sweets when he was ill who disliked them Avhen he was 
well, I have known many fond of them when in health, who 
in sickness would leave off any thing sweet, even to sugar in tea ; 
sweet puddings, sweet drinks are their aversion ; the furred tongue 
almost always likes what is sharp or pungent. Scorbutic patients 
are an exception ; they often crave for sweetmeats and jams. 

Jelly is another article of diet in great favor with nurses and 
friends of the sick ; even if it could be eaten solid, it would not 
nourish, but it is simply the height of folly to take J oz. of gela- 
tine and make it into a certain bulk by dissolving it in water, and 
then to give it to the sick, as if the mere bulk represented nourish- 
ment. It is now known that jelly does not nourish, that it has a 
tendency to produce diarrhea, and to trust to it to repair the waste 
of a diseased constitution is simply to starve the sick under the guise 
of feeding them. If 100 spoonfuls of jelly were given in the course 
of the day, you would have given one spoonful of gelatine, which 
spoonful has no nutritive power whatever. 

And, nevertheless, gelatine contains a large quantity of nitrogen, 
which is one of the most powerful elements in nutrition ; on the 
other hand, beef tea may be chosen as an illustration of great nu- 
trient power in sickness, coexisting with a very small amount of 
solid nitrogenous matter. 

Dr. Christison says that '^ every one will be struck with the 
readiness with which" certain classes of "patients will often take 
diluted meat-juice or beef tea repeatedly, when they refuse all 
other kinds of food." This is particularly remarkable in " cases of 
gastric fever, in which," he says, " little or nothing else besides 
beef tea or diluted meat-juice" has been taken for weeks or even 



646 AMEKICAN HOUSEHOLD BOOK OF MEDICINE. 

montlis, '^ and yet a pint of beef tea contains scarcely J oz. of any 
thino- but water " — the result is so strikino; that he asks what is its 
mode of action? "Not simply nutrient — J oz. of the most nutri- 
tive material can not nearly replace the daily wear and tear of the 
tissues in any circumstances. Possibly," he says, "it belongs to 
a new denomination of remedies." 

It has been observed that a small quantity of beef tea added to 
other articles of nutrition augments their power out of all propor- 
tion to the additional amount of solid matter. 

The reason why jelly should be innutritions and beef tea nutri- 
tious to the sick, is' a secret yet undiscovered, but it clearly shows 
that careful observation of the sick is the only clue to the best 
dietary. 

Chemistry has as yet afforded little insight into the dieting of 
sick. All that chemistry can tell us is the amount of " carbonifer- 
ous " or "nitrogenous" elements discoverable in different dietetic 
articles. It has given us lists of dietetic substances, arranged in 
the order of their richness in one or other of these principles ; but 
that is all. In the great majority of cases, the stomach of the pa- 
tient is guided by other principles of selection than merely the 
amount of carbon or nitrogen in the diet. No doubt, in this as in 
other things, nature has very definite rules for her guidance, but 
these rules can only be ascertained by the most careful observa- 
tion at the bedside. She there teaches us that living chemistry, 
the chemistry of reparation, is something different from the chem- 
istry of the laboratory. Organic chemistry is useful, as all knowl- 
edge is, when we come face to face with nature ; but it by no 
means follows that we should learn in the laboratory any one of 
the reparative processes going on in disease. 

Again, the nutritive power of milk and of the preparations from 
milk, is very much undervalued; there is nearly as much nourish- 
ment in half a pint of milk as there is in a quarter of a pound of 
meat; but this is not the whole question, or nearly the whole. 
The main question is, what the patient's stomach can assimilate or 
derive nourishment from; and of this the patient's stomach is the 
sole judge. Chemistry can not tell this. The patient's stomach 
must be its own chemist. The diet which will keep the healthy 
man healthy, will kill the sick one. The same beef which is the 
most nutritive of all meat, and which nourishes the healthy man, 
is the least nourishing of all food to the sick man, whose half-dead 



HOW TO NURSE THE SICK. 647 

stomacli can assimilate no part of it, that is, make no food out of 
it. On a diet of beef tea healthy men, on the other hand, speedily 
lose their strength. 

I have known patients live for many months without touching 
bread, because they could not eat baker's bread. These were 
mostly country patients, but not all. Home-made bread or brown 
bread is a most important article of diet for many patients. The 
use of aperients may be entirely superseded by it. 

To watch for the opinions, then, which the patient's stomach 
gives, rather than to read " analyses of foods," is the business of 
all those who have to settle what the patient is to eat — perhaps the 
most important thing to be provided for him after the air he is to 
breathe. 

Now the medical man who sees the patient only once a day, or 
even only once or twice a week, can not possibly tell this without 
the assistance of the patient himself, or of those who are in con- 
stant observation on the patient. The utmost the medical man 
can tell is, whether the patient is weaker or stronger at this visit 
than he was at the last visit. 

It is quite incalculable the good that would certainly come from 
such sound and close observation in this almost neglected branch 
of nursing. 

A great deal too much against tea is said by wise people, and a 
great deal too much of tea is given to the sick by foolish people. 
A little tea or coffee restores them quite as much as a great deal, 
and a great deal of tea, and especially of coffee, impairs the little 
power of digestion they have. 

Sleeplessness in the early night is from excitement generally, 
and is increased by tea or coffee ; sleeplessness which continues to 
the early morning is from exhaustion often, and is relieved by tea. 
In general, the dry and dirty tongue always prefers tea to coffee, 
and will quite decline milk, unless with tea. Coffee is a better re- 
storative than tea, but a greater impairer of the digestion. Let 
the patient's taste decide. You will say that, in cases of great 
thirst, the patient's craving decides that it will drink a great deal 
of tea, and that you can not help it. But in these cases be sure 
that the patient requires diluents for quite other purposes than 
quenching the thirst; he wants a great deal of some drink, not 
only of tea, but barley-water or lemonade, or soda-water and milk, 
a5 the case may be. 



648 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Lehman, quoted by Dr. Christison, says that, among the well 
and active, ''the infusion of 1 oz. of roasted coffee daily will di- 
minish the waste" going on in the body "by one-fourth," and 
Dr. Christison adds that tea has the same property. Now, this is 
actual experiment. Lehman weighs the man and finds the fact 
from his weight. It is not deduced from any " analysis " of food* 
All experience among the sick shows the same thing. 

Cocoa is often recommended to the sick in lieu of tea or coffee. 
It is an oily starchy nut, having no restorative power at all, but 
simply increasing fat. It is pure mockery of the sick, thereforoj 
to call it a substitute for tea. For any renovating stimulus it has^ 
you might just as well offer them chestnuts instead of tea. 

An almost universal error among nurses is in the bulk of the 
food, and especially the drinks they offer to their patients. Sup- 
pose a patient ordered 4 oz. brandy during the day, how is he to 
take this if you make it into four pints with diluting it? The 
same with tea and beef tea^ with arrowroot^ milk, etc. You have 
not increased the nourishment, you have not increased the reno- 
vating power of these articles, by increasing their bulk ; you 
have very likely diminished both by giving the patient's diges- 
tion more to do, and, most likely of all, the patient will leave half 
of what he has been ordered to take, because he can not swallow 
the bulk with which you have been pleased to invest it. It re- 
quires very nice observation and care to determine what will not 
be too thick or strong for the patient to take, while giving him 
no more than the bulk which he is able to swallow. 

A few words upon bedsteads and bedding; and principally as 
regards patients who are entirely, or almost entirely, confined to 
bed. 

Feverishness is generally supposed to be a symptom of fever; 
in nine cases out of ten it is a symptom of bedding. The patient 
has had re-introduced into the body the emanations from himself, 
which day after day and week after week saturate his unaired 
"bedding. 

If you consider that an adult in health exhales by the lungs and 
skin in the twenty-four hours three pints at least of moisturCj 
loaded with organic matter ready to enter into putrefaction; that 
in sickness the quantity is often greatly increased, the quality is 
always more noxious — -just ask yourself next where does all this 
moisture go to? Chiefly into the bedding, because it can not go 



HOW TO NUBSE THE SICK. 649 

anywhere else. And it stays there; because, except perhaps a 
weekly change of sheets, scarcely any other airing is attempted. 

A nurse will be careful to fidgetiness about airing the clean sheets 
from clean damp, but airing the dirty sheets from noxious damp 
will never even occur to her. Besides this, the most dangerous 
effluvia we know of are from the excreta of the sick ; these are 
placed, at least temporarily, where they must throw their effluvia 
into the underside of the bed, and the space under the bed is 
never aired; it can not be, with our arrangements. Must not 
such a bed be always saturated, and be always the means of re-in- 
troducing into the system of the unfortunate patient who lies in it, 
that excrementitious matter, to eliminate which from the body 
nature had expressly appointed the disease? 

There is a prejudice in favor of a wide bed — I believe it to be a 
prejudice. All the refreshment of moving a patient from one side 
to the other of his bed is far more effectually secured by putting 
him into a fresh bed ; and a patient who is really very ill does not 
stray far in bed. But it is said there is no room to put a tray down 
on a narrow bed. No good nurse will ever put a tray on a bed at 
all. If the patient can turn on his side, he will eat more comfort- 
ably from a bedside table ; and on no account whatever should a 
bed ever be higher than a sofa. Otherwise the patient feels him- 
self " out of humanity's reach;" he can get at nothing for himself, 
he can move nothing for himself. If the patient can not turn, a 
table over the bed is a better thing. I need hardly say that a pa- 
tient's bed should never have its side against the w^all. The nurse 
must be able to get easily to both sides of the bed, and to reach 
easily every part of the patient without stretching — a thing im- 
possible if the bed be either too wide or too high. 

If a bed is higher than a sofa, the difference of the fatigue of 
getting in and out of bed will just make the difference, very often, 
to the patient (who can get in and out of bed at all) of being able 
to take a few minutes' exercise, either in the open air or in another 
room. 

A patient's bed should always be in the lightest spot in the room ; 
and he should be able to see out of window. 

I need scarcely say that the old four-post bed, with curtains, is 
utterly inadmissible, whether for sick or well. Hospital bedsteads 
are, in many respects, very much less objectionable than private 
ones. 



650 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

There is reason to believe that not a few of the apparently un- 
accountable cases of scrofula among children proceed from the 
habit of sleeping with the head under the bedclothes, and so in- 
haling air already breathed, which is further contaminated by 
exhalations from the skin. Patients are sometimes given to a sim- 
ilar habit, and it often happens that the bedclothes are so dis- 
posed that the patient must necessarily breathe air more or less 
contaminated by exhalations from his skin. A good nurse will be 
careful to attend to this. It is an important part, so to speak, of 
ventilation. 

It may be worth while to remark, that where there is any dan- 
ger of bed-sores a blanket should never be placed under the patient. 
It retains damp, and acts like a poultice. 

Never use any thing but light blankets as bed covering for the 
sick. The heavy cotton impervious counterpane is bad, for the 
very reason that it keeps in the emanations from the sick person, 
while the blanket allows them to pass through. Weak patients 
are invariably distressed by a great weight of bedclothes, which 
often prevents their getting any sound sleep whatever. 

It is the unqualified result of all my experience with the sick, 
that second only to their need of fresh air is their need of light; 
that, after a close room, what hurts them most is a dark room ; 
and that it is not only light, but direct sunlight, they want. Peo- 
ple think the effect is upon the spirits only. This is by no means 
the case. The sun is not only a painter but a sculptor. You ad- 
mit that he does the photograph. Without going into any scien- 
tific exposition, we must admit that light has quite as real and 
tangible elTects upon the human body. But this is not all. Who 
has not- observed the purifying effect of light, and especially of 
direct sunlight, upon the air of a room? Here is an observation 
within every body's experience. Go into a room where the shut- 
ters are always shut (in a sick room or a bedroom there should 
never be shutters shut), and though the room be uninhabited, 
though the air has never been polluted by the breathing of human 
beings, you will observe a close, musty smell of corrupt air — of air 
unpurified by the efi'ect of the sun's rays. The mustiness of dark 
rooms and corners, indeed, is proverbial. The cheerfulness of a 
room, the usefulness of light in treating diseases is all-important. 

A very high authority in hospital construction has said that 
people do not enough consider the difference between wards and 



HOW TO NURSE THE SICK. 651 

dormitories in planning their buildings ; but I go further, and say- 
that healthy people never remember the difference between hed- 
rooms and szcA;-rooms, in making arrangements for the sick. To 
a sleeper in health it does not signify what the view is from his 
bed. He ought never to be in it excepting when asleep, and at 
night. Aspect does not very much signify either (provided ttee 
sun reach his bedroom some time in ever}^ day, to purify the air), 
because he ought never to be in his bedroom except during the 
hours when there is no sun. But the case is exactly reversed with 
the sick, even should they be as many hours out of their beds as 
you are in yours, which probably they are not. Therefore, that 
they should be able, without raising themselves or turning in bed, 
to see out of window from their beds, to see sky and sunlight at 
least, if you can show them nothing else, I assert to be, if not of 
the very first importance for recovery, at least something very 
near it. And you should, therefore, look to the position of the beds 
of your sick one of the very first things. If they can see out of 
two windows instead of one, so much the better. Again, the 
morning sun and the midday sun — the hours when they are quite 
certain not to be up — are of more importance to them, if a choice 
must be made, than the afternoon sun. Perhaps you can take 
them out of bed in the afternoon, and set them by the window, where 
they can see the sun. But the best rule is, if possible, to give 
them direct sunlight from the moment he rises till the moment he 
sets. 

Another great difference between the hedroom and the sick- 
room is, that the sleeper has a very large balance of fresh air to 
begin with, when he begins the night, if his room has been open 
all day, as it ought to be ; the sick man has not, because all day he 
has been breathing the air in the same room, and dirtying it by the 
emanations from himself. Far more care is therefore necessary to 
keep up a constant change of air in the sick-room. 

It is hardly necessary to add that there are acute cases (partic- 
ularly a few ojohthalmic cases, and diseases where the eye is mor- 
bidly sensitive), where a subdued light is necessary. But a dark 
north room is inadmissible even for these. You can always mod- 
erate the light by blinds and curtains. 

In almost all diseases, the function of the skin is, more or less, 
disordered; and in piany most important diseases nature relieves 
herself almost entirely by the skin. This is particularly the case 



652 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

with cliildren. But the excretion, which comes from the skin, is 
left there, unless removed by washing or by the clothes. Every 
nurse should keep this fact constantly in mind. 

The amount of relief and comfort experienced by sick after the 
skin has been carefully washed and dried, is one of the commonest 
observations made at a sick bed. But it must not be forgotten 
that the comfort and relief so obtained are not all. They are, in 
fact, nothing more than a sign that the vital powers have been re- 
lieved by removing something that was oppressing them. 

Care should be taken in all these operations of sponging, wash- 
ing, and cleansing the skin, not to expose too great a surface at 
once, so as to check the perspiration, which would renew the evil 
in another form. 

In several forms of diarrhea, dysentery, etc., where the skin is 
hard and harsh, the relief afforded by washing with a great deal 
of soft soap is incalculable. In other cases, sponging with tepid 
soap and water, then with tepid water, and drying with a hot towel, 
are beneficial. 

Every nurse ought to be careful to wash her hands very fre- 
quently during the day. If her face too, so much the better. 

Washing, however, with a large quantity of water has quite 
other effects than those of mere cleanliness. The skin absorbs 
the water, and becomes softer and more perspirable. To wash with 
soap and soft water is, therefore, desirable from other points of 
view than that of cleanliness. 

The most important practical lesson that can be given to nurses 
is to teach them what to observe, how to observe ; what symp- 
toms indicate improvement, what the reverse ; which are of im- 
portance, which are of none ; which are the evidence of neglect, 
and of what kind of neglect. 

All this is what ought to make part, and an essential part, of 
the training of every nurse. At present how few there are, either 
professional or unprofessional, who really know at all whether any 
sick person they may be with is better or worse. 

The vao;ueness and looseness of the information one receives in 
answer to that much abused question, "Is he better?" would be 
ludicrous, if it were not painful. 

Again, the question, How is your appetite? is often put when 
How is your digestion? is the question meant. No dcubt the tv.o 
things depend on one another ; but they are quite different. Many 



HOW TO NURSE THE SICK. 653 

a patient can eat, if you can only ^' tempt his appetite." The 
fault lies in your not having got him the thing that he fancies; 
but many another patient does not care between grapes and 
turnips — every thing is equally distasteful to him. He would try 
to eat any thing w^hich would do him good; but every thing "makes 
him worse." The fault here generally lies in the cooking. It is** 
not his '^ appetite " w^hich requires " tempting," it is his digestion 
which requires sparing ; but good sick cookery will save the diges- 
tion half its work. 

There may be four different causes, any one of which will pro- 
duce the same result, viz., the patient slowly starving to death 
from want of nutrition: 

1. Defect in cooking. 

2. Defect in choice of diet. 

8. Defect in choice of hours for taking diet. 

4. Defect of appetite in patient. 
Yet all these are generally comprehended in the one sweeping 
assertion that the patient has "no appetite.'^ 

Surely many lives might be saved by drawing a closer distinc- 
tion; for the remedies are as diverse as the causes. The remedy 
for the first is to cook better; for the second, to choose other articles 
of diet ; for the third, to watch for the hours when the patient is 
in want of food; for the fourth, to show him what he likes, and 
sometimes unexpectedly ; but no one of these remedies will do for 
any other of the defects not corresponding with it. 

Again, the question is sometimes put. Is there diarrhea? and 
the answer will be the same, whether it is just merging into cholera, 
whether it is a trifling degree brought on by some trifling indiscre- 
tion, which will cease the moment the cause is removed, or whether 
there is no diarrhea at all, but simply relaxed bowels. 

In the case of infants, every thing must depend upon the accu- 
rate observation of the nurse or mother who has to report; and 
how seldom is this condition of accuracy fulfilled. 



654 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



CHAPTER X. 

PHYSICAL TRAINING AND GYMNASTICS. 

Education may be divided into two parts, physical and mental. 
Of the former, Exercises or Gymnastics are the most extensive 
and the earliest portion. 

Their extent is learned by an enumeration of them, viz. : Walk- 
ing, Running, Leaping, Vaulting, Pole-leaping, Balancing, Skating, 
Carrying, Climbing, and Swimming; to which may be added Throw- 
ing the Discufe, Rowing, Sailing, Riding, and Driving, though itwill 
not be necessary to the purposes of this work to describe all. 

The object of these exercises is to strengthen the muscular sys- 
tem, by subjecting it to a regular process of training, and to teach 
the means of employing it most advantageously. The expediency 
of their early acquisition is rendered evident by the first tendency 
of youth being directed to them, by the rapid progress made in 
them, and by the delight derived from them, at a period when the 
body is incapable, with real or solid advantage, of higher acquire- 
ments. 

Their general utility will be questioned only by those who are 
not aware that the health and vigor of all the bodily orgai^s de- 
pend on the proportioned exercise of each. In active exertion, 
the member exercised swells with the more frequent and more 
copious flow of blood, and heat is developed in it with greater abun- 
dance ; and if we repeat the same motions many times after in- 
tervals of repose, all the muscles exercised become permanently 
developed; a perfection of action ensues in the member exercised, 
which it did not previously possess, any deformity by which it is 
affected is corrected, and strength and activity are acquired. That 
man, therefore, gains the most strength who engages in muscular 
exercises that require the application of much power, but which 
are sufliciently separated by intervals of repose. 



PHYSICAL TRAINING AND GYMNASTICS. 655 

It must be remembered, however, that in exercising particular 
muscles only, the others become weak. The strength of Marshal 
Saxe was sufficiently great to stop a chariot drawn at speed by four 
horses, by merely seizing the wheel; he bent pieces of silver with 
his fingers, made them into boats as he would with paper, and pre- 
sented them to the ladies. Count Orloff, a Russian general, broke'* 
the shoe of a carriage horse in the same manner; and there are 
innumerable examples of similar feats of extraordinary -strength. 

Active exercises, at the same time, confer beauty of form ; and 
they even contribute to impart an elegant air and graceful man- 
ners. If the exercise of a limb be continued for some time, the 
member SAvells, a painful sensation is experienced, which is termed 
lassitude, and a difficulty of contraction, Avhich is the result of it. 
If the motion has been excessive, and the organic elements in the 
member have been acted upon beyond all physiological laws, inflam- 
mation would take place, and its functions be performed with great 
difficulty, if at all. 

Such are the efiects of exercise on the locomotive system, to all 
the functions of animated beings, so long as they are exercised 
with moderation, equality, and at due intervals, working for their 
own preservation. Of course, the general effect of active exercises 
is marked in proportion to the number of parts that share in the 
motion, or are brought into energetic action. In general exercise, 
the increase of organic action is not confined solely to the parts 
which are the seat of muscular contraction, but is repeated through- 
out all parts of the economy, and influences all the functions. 

Thus, as to the vital or nutritive system, exercises taken when 
digestion is not going on, excite the digestive faculty ; taken dur- 
ing its progress, they disorder that function. The arterial and 
venous circulations become more rapid by active exercise, which 
concludes by giving greater force to the tissue of the heart. It is 
the same with respiration and calorification. The same takes place 
with regard to nutrition, a function which exercise increases, not 
only in the muscles in movement, as we have just seen, but also 
in the bones, ligaments, vessels, and nerves. 

By inducing cutaneous exhalation, it promotes the expulsion of 
injurious agents, produces a fresh color in persons who may have 
become pale through a sedentary life, and, to a certain extent, 
renders the human constitution, by means of habit, proof against 
the action of surrounding objects. The local effects of excessive 



656 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

action, or those which take place in the members themselves, are, 
as before observed, inflammation of the muscles, rheumatism, like 
that arising from cold, and inflammation of the serous articular 
membranes. The general efl'ects of excessive exercise may, in 
the same manner as all physical and moral stimulants, exhaust 
the vital faculties too quickly, communicate too much rigidity to 
the fibers, render the vessels varicose, bring on chronic rheuma- 
tism, destroy the freshness of the skin, blight the flower of youth, 
and produce old age and death before the time ordained by nature. 

Ancient writers inform us that it was a rare thing to meet with 
athletes, who, having signalized themselves from their earliest 
youth in gymnastic combats, were of so excellent a constitution as 
to be able, when they had reached a more advanced age, to acquire 
the same honors on contending for the prize with grown men. 
Aristotle assures us, that among the conquerors in the Olympic 
Games, not more than two or three at the most could be found to 
whom nature had granted such an advantage. 

In relation to the mental or thinking system, " every move- 
ment," says Cabanis, " becomes, in its turn, the principle or oc- 
casion of new impressions, of which the frequent repetition and 
the varied character must increase more and more the circle of our 
judgments, or tend unceasingly to rectify them. It hence follows 
that labor, giving to this word the most general signification, can 
not but have an influence infinitely useful on the habits of the un- 
derstanding, and consequently also on those of the will." This 
argument is evidently applicable to varied exercise. On the con- 
ti aiy, " the great division of labor, so favorable to the perfecting 
of the arts, contracts more and more the understanding of work- 
men." Exercises, moreover, inspire confidence in difficult situa- 
tions, and suggest resources in danger. Their consequent influ- 
ence upon the moral conduct of man is such that, by a courage 
which is well founded, because it springs from a perfect knowledge 
of his own powers, he is often enabled to render the most impor- 
tant services to others. 

Although the direct efi'ect of exercise is not only to confer power 
on the muscular and other organs, but to multiply external im- 
pressions, end to occupy with them all the senses at once, still, 
minds thus disposed, in general, occupy themselves rather with ob- 
jects of imagination and sentiment than with those which demand 
more complicated operation. The sense of muscular power impresses 



PHYSICAL TRAINING AND GYMNASTICS. 657 

determinations, which, carrying man perpetually out of himself, 
scarcely permit him to dwell upon impressions transmitted to his 
brain. The only action of that organ, during these exercises, 
seems to be limited to ordering the movements. 

Hence, exercise, especially taken in the open air, amid new 
and varied objects of sight, is not favorable to reflection — to labors 
which demand the assemblage and concentration of all the powers 
of the mind. It is, on the contrary, in the absence of external 
impressions, that we become more capable of seizing many rela- 
tions, and of following a long train of purely abstract reasoning. 
As life spent chiefly in active muscular exercises would leave in a 
state of repose those central organs that are subservient to the 
moral qualities and intellectual faculties, we agree with Seneca and 
Camper, in proscribing all such exercises, or such degrees of exer- 
cise, as would exhaust the mind, and render man incapable of apti- 
tude in science, polite literature, and art. 

The cultivation of bodily strength, in preference to every thing 
else, would establish only the right of the strongest, as it is found 
to exist in the origin of society. To cultivate the faculties of the 
mind exclusively, would produce only the weakness of sentiment 
or excess of passion. There is, for every individual, a means of 
making all these dispositions act in harmony ; and the due blend- 
ing of physical and moral education alone can produce it. Let it 
be remembered that young persons will much more easily be with- 
drawn from the application they ought to pay to the study of the 
sciences, by insipid recreations and trifling games, than by the fatig- 
uing exercises necessary for their development and the preserva- 
tion of their health, which, however, habit soon renders easy and 
dehghtful. To what vices do not a sedentary life and the prac- 
tice of gaming give rise ? while well-regulated exercises excite am- 
bition to excel, and energy in the performance of every duty. 

The philosophers of antiquity, such as Aristotle and Plato, re- 
garded gymnastic exercises as of vast importance, and considered 
a state defective and badly organized where these exercises were 
not instituted. Colleges, called Gymnasia, were therefore estab- 
lished every-where, and superintended by distinguished masters. 
Accordingly, the illustrious men of the Grecian and Roman repub- 
lics, even those who shone in literature and the fine arts, received 
the same physical education. The gymnastic exercises which are 
here recommended are not intended to produce athletes, but to 
42 



658 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

strengthen tlie human constitution. One exercise gives solidity,, 
another address ; and we may even say that the various kinds of 
exercise are sometimes opposed to each other. The strongest 
peasant is far from being the best runner ; and the most vigorous 
dancer would probably be deficient in strength. There is, how- 
ever, a mean to be found in the disposition of every individual to 
preserve both skill and strength, and this is what ought to be 
sought. For this purpose, it will suffice to practice young persons 
a few hours every day, sometimes at one exercise and sometimes 
at another ; and even half an hour of vigorous gymnastic exercise 
each day will do much to establish and preserve both physical and 
mental health. 

General Directions. 

It only remains for us to give a few directions as to the time, 
place, and circumstances of exercise. The best time for the ele- 
mentary exercises is when the air is cool, as, even in summer, it 
is early in the morning, or after the sun has declined ; and they 
should never immediately follow a meal. The best place for these 
elementary exercises is a smooth grass-plat, or a firm sandy sea- 
beach. Chasms, stones, and stakes are always dangerous. At 
the commencement, the coat and all unnecessary clothes should be 
laid aside ; and all hard or sharp things should be taken from the 
pockets of the remaining dress. A very light covering on the 
head, as a straw hat, is best ; the shirt- collar should be open, the 
breast being either exposed or thinly covered and the waistband 
of the trousers should not be tight. 

As sudden transitions are always bad, exercise should begin 
gently, and should terminate in the same manner. The left hand 
and arm being commonly weaker than the right, they should be 
exercised till they become as strong. This custom is advantageous, 
not only for all military and mechanical gymnastic exercises, but 
also for all their operations. The being cooled too quickly is in- 
jurious. Therefore, drinking when very hot, or lying down on 
the cold ground, should be carefully avoided. No exertion should 
be carried to excess, as that only exhausts and enfeebles the body. 
Therefore, whenever the gymnast feels tired, or falls behind his 
usual mark, he should resume his clothes, and walk home. The 
moment exercise is finished, the clothes should always be put on, 
and the usual precautions adopted to prevent taking cold. 



PHYSICAL TRAINING AND GYMNASTICS. 659 

The necessary fittings-up of an exercising ground are a leaping- 
standj a vaulting-liorse, a balancing-bar, a climbing-stand, with 
ladders, poles, and ropes. 

In most exercises, a belt or cincture is of utility ; and it seems, 
in all ages, to have been naturally employed. The weakest savage, 
who could not follow others in the course without panting, would 
find, by placing his hand over his abdomen, and supporting the 
liver and other organs which descend into that cavity, that he was 
aided in running, and breathed more easily ; and thence he would 
make for himself a belt. United in societies, men would still pre- 
serve their belt, though it might not seem particularly advanta- 
geous, except to those whose active mode of life approached a 
primitive state, such as travelers, couriers, and porters. 

The Greeks put on their belts before they commenced wrestling ; 
and many physicians, both ancient and modern, recommend the 
use of belts, as being to the whole of the body, and to the parts 
over which they are placed, what the exterior sheaths or aponeur- 
oses are to the muscles — bands which embrace and keep firm the 
parts over which they are placed. The common belt has leathern 
straps, and buckles to fasten it, an iron ring, and a pocket. A 
double cincture for wrestling forms a very strong girth, which is 
put on by pupils w^ho are very strong, when they wrestle. These 
belts may be made of diiferent sizes, for youths of difi"erent ages : 
of five or six inches for tall youths and men, and of eight or ten 
inches for wrestlers. Their length is in proportion to the size of 
the person who uses them. These belts are very useful in 
strengthening the abdominal region in running and leaping. Ri- 
ders, also, should furnish themselves wdth belts before getting on 
horseback, to prevent too violent motion of the viscera of the ab- 
domen, and the disorders which may result from it. The use, in- 
deed, of belts will by degrees prove their utihty, and they will 
probably be worn even externally, without reference to physical 
exercises. They deserve this the more, because they give an air 
of lightness and elegance to the shape, and develop the chest. 

The mtst useful thing in existence is dangerous, if improperly 
applied. In very young persons, the chest and abdomen have 
been compressed by fastening the belt too tight, or making it too 
wide ; and disorders of digestion and respiration have consequently 
been caused by pushing in the false ribs. This is an imprudence 
that should be avoided. If the belt be too low, it may press too 



660 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

mucli on the lower part of the belly ; if too high, it may disorder 
the chest. It must, therefore, be placed on the loins, so as to 
pass over the navel; and, as said before, it must not be too tighL 

TRAININa. 

This is important in relation to various exercises to be described. 
The art of training for athletic exercises, or laborious exertions, 
consists in purifying the body and strengthening its powers, by 
certain processes, which are now to be described. The advan- 
tages of it, however, are not confined to pedestrians, wrestlers, or 
pugilists ; they extend to every one ; for, were training generally 
introduced, instead of medicine, for the prevention and cure of 
diseases, its beneficial consequences would assuredly prolong life 
and promote its happiness. Every physiologist knows that all the 
parts which compose the human body — solids as well as liquids — 
are successively absorbed and deposited. Hence ensues a perpet- 
ual renovation of them, regulated by the nature of our food and 
general habits. The health of all the parts, and the soundness of 
their structure, depend on this perpetual absorption and renova- 
tion. Now, nothing so effectually as exercise excites at once ab- 
sorption and secretion. It accordingly promotes all the vital func- 
tions without hurrying them, renovates all the parts, and preserves 
them apt and fit for their ofiices. 

It follows, then, that health, vigor, and ac;tivity chiefly depend 
upon exercise and regimen ; or, in other words, upon the observ- 
ance of those rules which constitute the theory of training. The 
effect has accordingly corresponded with the cause assigned in this 
view of the subject, in every instance where it has been adopted ; 
and, although not commonly resorted to as the means of restoring 
invalids to health, there is every reason to believe that it would 
prove effectual in curing many obstinate diseases, such as bilious 
complaints, obesity, gout, and rheumatism. 

The ancients entertained this o-pinion. They were, says a pop- 
ular writer on medicine, by no means unacquainted with* or inat- 
tentive to these instruments of medicine, although modern practi- 
tioners appear to have no idea of removing disease, or restoring 
health, but by pouring drugs into the stomach. Heroditus is said 
to have been the first who applied the exercises and regimen of 
the gymnasium to the removal of disease or the maintenance of 



PHYSICAL TRAINING AND GYMNASTICS. 661 

health. Among the Romans, Asclepiades carried this so far, that 
he is said, by Celsus, ahuost to have banished the use of internal 
remedies from his practice. He was the inventor of various modes 
of exercise and gestation in Rome. In his OAvn person he afforded 
an excellent example of the wisdom of his rules, and the propriety 
of his regimen. Pliny tells us that, in early life, he made a pub- 
lic profession, that he would agree to forfeit all pretensions to the 
name of a physician should he ever suffer from sickness, or die 
but of old age ; and, what is extraordinary, he fulfilled his prom- 
ise, for he lived upward of a century, and at last was killed by a 
fall down stairs. 

As to the locomotive system, modern experience sufficiently 
proves that exercise is the most powerful strengthener of the mus- 
cles, and of every part on which activity depends. In its opera- 
tion on the vital system, training always appears to benefit the 
state of the lungs. Indeed, one of its most striking effects is to 
improve the wind; that is, to enable a man to draw a larger in- 
spiration, and to hold his breath longer. As to the intellectual 
system. Sir J. Sinclair observes, that, by training, the mental facul- 
ties are also improved, the attention being more ready, and the 
perception more acute, owing probably to the clearness of the 
stomach, and better digestion. 

It must, therefore, be admitted, that the most beneficial conse- 
quences to general health arise from training. The simplicity of 
the rules for it is assuredly a great recommendation to a trial of 
the experiment. The whole process may be resolved into the fol- 
lowing principles : 1st, the evacuating, which cleanses the stomach 
and intestines ; 2d, the sweating, which takes off the superfluities 
of fat and humors ; 3d, the daily course of exercise, which im- 
proves the wind and strengthens the muscles ; and, lastly, the reg- 
imen, which nourishes and invigorates the body. To those who 
are to engage in corporeal exercises beyond their ordinary powers, 
it is indispensably necessary. Pedestrians, therefore, who are 
matched either against others or against time, and pugilists who 
engage to fight, must undergo the training process before they con- 
tend. The issue of the contest, if their powers be nearly equal, 
will, in a great measure, depend upon their relative condition, as 
effected by training, at the hour of trial. • 

Training was known to the ancients, who paid much attention to 
the means of augmenting corporeal vigor and activity. Accord- 



662 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

ingly, among the Greeks and Romans, certain rules of exercise 
and regimen were prescribed to the candidates for gymnastic celeb- 
rity. We are assured that, among the Greeks, previously to the 
solemn contests at the public games, the strictest temperance, so- 
briety, and regularity in living were indispensably requisite. The 
candidates were, at the same time, subjected to daily exercise in 
gymnasium, which continued during ten months, and which, with the 
prescribed regimen, constituted the preparatory training adopted 
by the athletae of Greece. Among the Romans, the exercises of 
the palaestra degenerated from the rank of a liberal art, and be- 
came a profession, which was embraced only by the lowest of man- 
kind, the exhibitions of the gladiators being bloody and ferocious 
spectacles, which evinced the barbarous taste of the people. The 
combatants, however, were regularly trained by proper exercise, 
and a strict observance of regimen. Pure and salubrious air was 
deemed a chief requisite. Accordingly, the principal schools of 
their athletse were established at Capua and Ravenna, the most 
healthy places in Italy ; and previous to entering on this regimen, 
the men were subjected to the evacuating process, by means of 
emetics, which they preferred to purgatives. 

In the more early stages of training, their diet consisted of dried 
figs, new cheese, and boiled grain. Afterward animal food was 
introduced as a part of the athletic regimen, and pork was prefer- 
red to any other. Galen, indeed, asserts that pork contains more 
real nutriment than flesh of any other kind which^is used as food 
by man. This fact, he adds, is decidedly proved by the example 
of the athletae, who, if they live but for one day on any other kind 
of food, find their vigor manifestly impaired the next. The prefer- 
ence given to pork by the ancients, however, does not correspond 
with the practice of modern trainers, who entirely reject it ; but 
in the manner of preparing the food, they exactly agree — roasting 
or broiling being by both preferred to boiling, and bread unfer- 
mented to that prepared by leaven. A very small quantity of 
liquid was allowed to the athletse, and this was principally water. 
They exercised in the open air, and became familiarized by habit 
to eVery change of the weather, the vicissitudes of which soon 
ceased to affect them. 

To exercise their patience, and accustom them to bear pain with- 
out flinching, they were occasionally flogged on the back with the 
branches of a kind of rhododendron, till the blood flowed. By 



PHYSICAL TRAINING AND GYMNASTICS, 

diminisliing the quantity of the circulating liquid, this rough hind of 
cupping Tvas also considered salutary ! as obviating the tendency 
to plethora or redundancy of blood, to whifch they were pecuharly 
liable — a proof, if true, of the nourishing qualities of their food. 

When the daily exercises of the athletse were finished, they were 
refreshed by immersion in a tepid bath, where the perspiration-'^nd 
sordes — scurf, pustules, or filthy adhesions — were carefully re- 
moved from the surface of the body by the use of the strygil.* 
The skin was then dihgently rubbed dry, and again anointed with 
oil. If thirsty, they were permitted to drink a small quantity of 
warm water. They then took their principal repast, after which 
they used no more exercise that day. They occasionally also 
went into the cold bath in the morning. They were permitted to 
sleep as many hours as they chose ; and great increase of vigor, 
as well as of bulk, was supposed to be derived from long-continued 
and sound repose. f The sexual intercourse was strictly prohibited. 

The manner of training among the ancients bears some resem- 
blance to that practiced by the moderns. Perhaps It is because 
their mode of living and general habits were somewhat difi'erent 
from those of the present age, that a difference of treatment is now 
required to produce the same effects. The great object of train- 
ing for running or boxing matches, is to increase the muscular 
strength, and to improve the free action of the lungs, or wind, of 
the person subjected to the process. Seeing that the human body 
is so capable" of being altered and renovated, it is not surprising 
that the art of training should be carried to a degree of perfection 
almost incredible; and that, by certain processes, the muscular 
power, the breath (or wind), and the courage of man, should be so 
greatly improved as to enable him to perform the most severe or 
laborious undertakings. 

That such effects have been produced is unquestionable; they 
are fully exemplified in the astonishing exploits of our most cele- 
brated pedestrians and pugilists, which are the infallible results of 
such preparatory discipline. The skillful trainer attends to the 
state of the bowels, the lungs, and the skin; and he uses such 



* For this instrument, rough coarse cloths are adopted, but not with advan- 
tage. 

t Little sleep is now prescribed; but its quantity should depend upon circum- 
gtances of fatigue, etc. 



664 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

means as will reduce the fat, and, at the same time, invigorate the 
muscular fiber. The patient is purged by drastic medicines ; he is 
sweated by walking under a load of clothes, and by lying between 
feather beds ; and his limbs are roughly rubbed. His diet is beef 
or mutton ; his drink, strong ale. He is gradually inured to exer- 
cise^by repeated trials in walking and running. By extenuating 
the fat, emptying the cellular substance, hardening the muscular 
fiber, and improving the breath, a man of the ordinary frame may 
be made to fight for one hour, with the utmost exertion of strength 
and courage, or to go over one hundred miles in twenty-four hours. 

The most effectual process for training appears to be that .prac- 
ticed by Captain Barclay, which has not only been sanctioned by 
professional men, but has met with the unqualified approbation of 
amateurs. We are here, therefore, almost entirely in(febted to it 
for details. According to this method, the pedestrian, who may be 
supposed in tolerable condition, enters upon his training with a 
regular course of physic, which consists of three doses. Glauber's 
salts are generally preferred ; and from one ounce and a half to two 
ounces are taken each time, with an interval of four days between 
each dose. After having gone through the course of physic, he 
commences his regular exercise, which is gradually increased as 
he proceeds in the training. 

When the object in view is the accomplishment of a pedestrian 
match, his regular exercise may be from twenty to twenty-four 
miles a day. He must rise at five in the morning, run half a mile 
at the top of his speed up-hill, and then walk six miles at a mod- 
erate pace, coming in about seven to breakfast, which should con- 
sist of beef-steaks or mutton-chops, underdone, with stale bread 
and old beer. After breakfast, he must again walk six miles at a 
moderate pace, and at twelve lie down in bed, without his clothes, 
for half an hour. On getting up, he must walk four miles, and 
return by four to dinner, which should also be beef-steaks or mut- 
ton-chops, with bread and beer, as at breakfast. Immediately after 
dinner, he must resume his exercise, by running half a mile at the 
top of his speed, and walking six miles at a moderate pace. He 
takes no more exercise for that day, but retires to bed about eight; 
and next morning he proceeds in the same manner. 

Animal diet, it will be observed, is, according to this system, 
alone prescribed, and beef and mutton are preferred. All fat and 
greasy substances are prohibited, as they induce bile, and, conse- 



PHYSICAL TRAINING AND GYMNASTICS. 665 

quently, injure the stomach. The lean of meat contams more nour- 
ishment than the fat ; and, in every case, the most substantial food 
is preferable to any other kind. Fresh meat is the most whole- 
some and nourishing. Salt, spiceries, and all kinds of seasonings, 
with the exception of vinegar, are prohibited. The lean, then, of 
fat beef, cooked in steaks, with very little salt, is the best; and it^ 
should be rather underdone than otherwise. Mutton, being reck- 
oned easy of digestion, may be occasionally given, to vary the 
diet and gratify the taste. The legs of fowls are also esteemed. 

It is preferable to have the meat broiled, as much of its nutri- 
tive quality is lost by roasting or boiling. It ought to be dressed, 
so as to remain tender and juicy ; for it is by these means that it 
will be easily digested, and afford most nourishment. Biscuit and 
stale bread are the only preparations of vegetable matter which 
are permitted to be given ; and every thing inducing flatulency 
must be carefully avoided. In general, the quantity of aliment is 
not limited by the trainer, but left entirely to the discretion of the 
pedestrian, whose appetite should regulate him in this respect. 

With respect to liquors, they must be always taken cold; and 
home-brewed beer, old, but not bottled, is the best. A little red 
wine, however, may be given to those who are not fond of malt 
liquor ; but never more than half a pint after dinner. It is an es- 
tablished rule to avoid liquids as much as possible; and no more 
liquor of any kind is allowed to be taken than is requisite to quench 
the thirst. 

After having gone on in this regular course for three or four 
weeks, the pedestrian must take a four-mile sweat, which is pro- 
duced by running four miles in flannel, at the top of his speed. 
Immediately on returning, a hot liquor is prescribed, in order to 
promote the perspiration; and of this he must drink one pint. It 
is termed the sweating liquor, and is composed of one ounce of 
carraway seed, half an ounce of coriander seed, one ounce of root- 
liquorice, and half an ounce of sugar-candy, mixed with two bot- 
tles of cider, and boiled down to one-half. He is then put to 
bed in his flannels, and, being covered with six or eight pair of 
blankets and a feather bed, must remain in thia state for twenty- 
five or thirty minutes, when he is taken out, and rubbed perfectly 
dry. Being then well wrapped in his great-coat, he walks out 
gently for two miles, and returns to breakfast, which should consist 
of roasted fowl. He afterward proceeds with his usual exercise. 



666 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

These sweats are continued weekly, till within a few days of 
the performance of the match ; or, in other words, he must undergo 
three or four of these operations. If the stomach of the pedes- 
trian be foul, an emetic or two must be given about a week before 
the conclusion of the training. He is now supposed to be in the 
highest condition. 

Besides his usual or regular exercise, a person under training 
ought to employ himself, in the intervals, in every kind of exer- 
tion which tends to activity, such as golf, cricket, bowls, throwing 
quoits, etc., so that during the whole day both body and mind may 
be constantly occupied. Although the chief parts of the system 
depend upon sweating, exercise, and feeding, yet the object to be 
obtained by the pedestrian would be defeated, if these were not 
adjusted each to the other, and to his constitution. The trainer, 
before he proceeds to apply his theory, should make himself ac- 
quainted with the constitution and habits of his patient, that he 
may be able to judge how far he can, with safety, carry on the 
different parts of the process. The nature of the patient's dispo- 
sition should also be known, that every cause of irritation may be 
avoided; for, as it requires great patience and perseverance to un- 
dergo training, every expedient to soothe and encourage the mind 
should be adopted. 

The skillful trainer will, moreover, constantly study the progress 
of his art, by observing the effect of its processes, separately and 
in combination. If a man retain his health and spirits during the 
process, improve in wind, and increase in strength, it is certain 
that the object aimed at Avill be obtained; but, if otherwise, it is 
to be apprehended that some defect exists, through the unskillful- 
ness or mismanagement of the trainer, which ought instantly to be 
remedied by such alterations as the circumstances of the case may 
demand. It is evident, therefore, that in many instances the 
trainer must be guided by his judgment, and that no fixed rules of 
management can, with absolute certainty, be depended upon for 
producing an invariable and determinate result. In general, how- 
ever, it may be calculated that the known rules are adequate to the 
purpose, if the pedestrian strictly adhere to them, and the trainer 
bestow a moderate degree of attention to his state and condition 
during the progress of training. 

It is impossible to fix any precise period for the completion of 
the training process, as it depends upon the previous condition of 



PHYSICAL TRAINING AND GYMNASTICS. 667 

the pedestrian ; but from two to three months, in most cases, mil 
be sufficient, especially if he be in tolerable condition at the com- 
mencement, and possessed of sufficient perseverance and courage 
to submit cheerfully to the privations and hardships to which he 
must unavoidably be subjected. The criterion by which it may be 
known whether a man is in good condition — or, what is the same 
thing, whether he has been properly trained — is the state of the 
skin, which becomes smooth, elastic, and well-colored, or transpar- 
ent. The flesh is also firm, and the person trained feels himself 
light and full of spirits. In the progress of the training, his 
condition may also be ascertained by the effect of the sweats, which 
cease to reduce his weight, and by the manner in which he per- 
forms one mile at the top of his speed. It is as difficult to run a 
mile at the top of one's speed as to walk a hundred; and, there- 
fore, if he performs this short distance well, it may be concluded 
that his condition is perfect, or that he has derived all the advan- 
tages which can possibly result from the training process. 



Position. 

Before entering into a detail of exercises, it is necessary to at- 
tend to what is termed position. A standing position is the action 
by which we keep ourselves up. Indeed, this state, in which the 
body appears in repose, is itself an exercise, for it consists in a 
continued effort of many muscles; and the explanation we shall 
give of it will much facilitate that of Avalking. 

Every one has observed that during sleep, or a fainting fit, the 
head inclines forward and falls upon the breast. In this case, it is 
in accordance with the laws of gravity ; for the head, resting upon 
the vertebrae which support it at a point of its basis which is nearer 
the posterior than anterior part, can not remain in an upright po- 
sition in standing, except by an effort of the muscles at the back 
of the neck ; it is the cessation of this effort that causes it to fall 
forward. The body also is unable to remain straight without fa- 
tigue. The vertebral column being placed behind, all the viscera 
or parts contained by the chest and belly are suspended in front 
of it, and would force it to bend forward unless strong muscular 
fibers held it back. A proof of this may be seen in pregnant and 
dropsical women, who are compelled, in consequence of the ante- 
rior part of the body being heavier than usual, to keep the verte- 



668 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

bral column more fixed, and even thrown backward. The same 
observation may be made with regard to the pelvis, basin, or lowest 
part of the trunk, which by its conformation would bend upon the 
thighs, if not kept back by the great mass of muscular fibers that 
form the hips. In front of the thighs, again, are the muscles, 
which, by keeping the knee-pan in position, are the means of pre- 
venting the leg from bending. Lastly, the muscles forming the 
calves, by contracting, are the means of preventing the leg from 
bending upon the foot. 

Such is the general mechanism of the standing position. It is, 
therefore, as we observed, a concurrence of efforts ; almost all the 
extending muscles are in a state of contraction all the time that 
this position is maintained, and the consequence is, a fatigue which 
can not be endured for any great length of time. Hence we see 
persons in a standing position rest the weight of their body, first 
on one foot, then on another, for the purpose of procuring moment- 
ary ease to certain muscles. For this reason, also, standing still 
is more fatiguing than walking, in which the muscles are alter- 
nately contracted and extended. 

A question of importance on this subject is. What position of the 
feet affords the greatest solidity in standing ? We will not enter 
into a detail of the numerous controversies by which some have 
defended or repudiated the position with the toes turned forward 
or outward ; it will be sufficient to state the fact, that the larger 
the base of support, the firmer and more solid will the position be, 
and to adopt, as a fundamental one, the military position, which 
has been found practically the best by those who have nothing else 
to do but to walk. The equal squareness of the shoulders and 
body to the front is the first great principle of position. The heels 
must be in a line, and closed ; the knees straight ; the toes turned 
out, with the feet forming an angle of sixty degrees ; the arms 
hanging close to the body ; the elbows turned in, and close to the 
sides ; the hands- open to the front, with the view of preserving the 
elbow in the position above described ; the little fingers lightly 
touching the clothing of the limbs, with the thumb close to the 
forefinger ; the belly rather drawn in, and the breast adva.nced, but 
without constraint; the body upright, but inclining forward, so 
that the weight of it may principally bear upon the forepart of the 
feet; the head erect, and the eyes straight to the front. (Fig. 1.) 

To these brief directions I must add that, in standing, the whole 



PHYSICAL TRAINING AND GYMNASTICS. 



669 



figure should be in sucli a position that the ear, shojilder, haunch, 
knee, and ankle are all in a line ; that it must be stretched as much 
as possible, by raising the back of the head, drawing in the chin, 
straightening the spine, rising on the hips, and extending the legs; 
that the object of keeping the back thus straight is to allow of 
standing longer without fatigue ; that it is important to expand 
the chest, and to throw the shoulders back, with the shoulder-blades, 
or scapulae, quite flat behind ; and that though, in military instruc> 
tions, the body is thus inclined forward in standing without arms, 
yet when these are assumed, the body is immediately thrown about 
two inches backward, into a nearly perpendicular position. This 
position, therefore, will be modified in walking, and especially in 
ordinary walking ; but it is an excellent fundamental position, and 
it can not be too accurately acquired. 






Extension Motions. — In order to supple the figure, open the 
chest, and give freedom to the muscles ; the first three movements 
of the extension motions, as laid down for the sword exercise, are 
ordered to be practiced. It is, indeed, observed that too many 
methods can not be used to improve the carriage, and banish a rus- 
tic air ; but that the greatest care must be taken not to throw the 
body backward instead of forward, as being contrary to every true 
principle of movement. I accordingly here introduce these exten- 
sion motions, adding the fourth and fifth, and prefixing to each the 



670 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

respective word of command, in order that they may be the more 
distinctly and accurately executed. 

Attention — The body is to be erect, the heels close together, 
and the hands hanging down on each side. First extension mo- 
tion. — This serves as a caution, and the motions tend to expand 
the chest, raise the head, throw back the shoulders, and strengthen 
the muscles of the back. 

One — Bring the hands and arms to the front, the fingers lightly 
touching at the points, and the nails downward; then raise them 
in a circular direction well above the head, the ends of the fingers 
still touching, the thumbs pointing to the rear, the elbows pressed 
back, and shoulders kept down. (Fig. 2.) 

Two — Separate and extend the arms and fingers, forcing them 
obliquely back, till they come extended on aline with the shoulders; 
and as they fall gradually from thence to the original position of 
attention, endeavor, as much as possible, to elevate the neck and 
chest. These two motions should be frequently practiced, with 
head turned as much as possible to the right or left, and the body 
kept square to the front; this tends very materially to supple the 
neck, etc. 

Three — Turn the palms of the hands to the front, pressing back 
the thumbs with the arms extended, and raise them to the rear, 
till they meet above'the head; the fingers pointing upward, with 
the ends of the thumbs touching. 

Four — Keep the arms and knees straight, and bend over from 
the hips till the hands touch the feet, the head being brought down 
in the same direction. (Fig. 3.) 

Five — With the arms flexible and easy from the shoulders, raise 
the body gradually, so as to resume the position of Attention. 
The whole should be done very gradually, so as to feel the exer- 
tion of the muscles throughout. To these extension motions, drill- 
sergeants, in their instructions, add the following: 

One — the forearms are bent upon the arms upward and toward 
the body, having the elbows depressed, the shut hands touching on 
the little-finger sides, and the knuckles upward, the latter being 
raised as high as the chin, and at the distance of about a foot be- 
fore it. (Fig. 4.) 

Two — While the arms are thrown forcibly backward, the fore- 
arms are as much as possible bent upon the arms, and the palmar 
sides of the wrists are turned forward and outward. (Fig. 5.) The 



PHYSICAL TRAINING AND GYMNASTICS. 



671 



two motions are to be repeatedly and rather quickly performed. A 
modification of the same movement is performed as a separate ex- 
tension motion, but may be given in continuation, with the num- 
bers following these, as words of command. 





Tliree — The arms are extended at full length in front, on a level 
with the shoulder, the palms of the hands in contact. (Fig. 6.) 

Four — Thus extended, and the palms retaining their vertical 
position, the arms are thrown forcibly backward, so that the backs 
of the hands may approach each other as nearly as possible. These 
motions, also, are to be repeatedly and rather quickly performed. 
Another extension motion, similarly added, consists in swinging 
the right arm in a circle, in which, beginning from the pendent 
position, the arm is carried upward in front, by the side of the 
head, and downward behind, the object being, in the latter part of 
this course, to throw it as directly backward as possible. The 
same is then done with the left arm. Lastly, both arms are thus 
exercised together. These motions are performed quickly. 



The Indian Club Exercise. 

1st. A club is held by the handle, pendent on each side (Fig. 
7) ; that in the right hand is carried over the head and left shoulder, 
until it hangs perpendicularly on the right side of the spine (Fig, 
8) ; that in the left hand is carried over the former, in exactly the 
opposite direction (fig. 8), until it hangs on the opposite side; 



672 



AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



holding both clubs still pendent, the hands are raised somewhat 
higher than the head (fig. 9) ; with the clubs in the same position, 




both arms are extended outward and backward (fig. 12) ; they are 
lastly dropped into the first position. All this is done slowly. 




2d. Commencing from the same position, the ends of both clubs 
are swung upward until they are held, vertically and side by side, 



PHYSICAL TRAINING AND GYMNASTICS. 



673 



at arm's length in front of the body, the hands being as hicrh as 
the shoulders (fig. 10) ; they are next carried m the same position, 
at arm's length, and on the same level, as far backward as possi- 
ble (fig. 11) ; each is then dropped backward until it hangs verti- 
cally downward (fig. 12) ; 
and this exercise ends as 
the first. Previous, how- 
ever, to dropping the clubs 
backward, it greatly im- 
proves this exercise, by a 
turn of the wrist upward 
and backward, to carry 
the clubs into a horizon- 
tal position behind the 
shoulders, so that, if long 
enough, their ends would 
touch (fig. 13) ; next, by 
a turn of the wrist out- 
ward and downward, to 
carry them horizontally 
outward (fig. 14) ; then by 
a turn of the wrist upward 
and forward, to carry them 
into a horizontal position 
before the breast (fig. 15) ; 
again to carry them hori- 
zontally outward; and fi- 
nally to drop them back- 
ward as already explained; 
and thence to the first 
position. xlU this is also 
done slowly. 

3d. The clubs are to be 
swung by the sides, first 
separately, and then together, exactly as the hands were in the last 
extension motion. 

4th. A club is held forward and upright in each hand, the fore- 
arm being placed horizontally, by the haunch on each side (fig. 
16) ; both are thrown in a circle upward, forward, and, by a turn 
of the wrist, downward and backward, so as to strike under the 
43 




674 



AMERICAN HOUSEHOLD EOOK OF MEDICINE, 



arms (fig. 17) ; by an opposite movement, both are thrown back 
again in a similar circle, till they swing over the shoulders (fig. 
18) ; and this movement is continued as long as agreeable. 




16 



17 



18 



5th. The clubs are held obliquely upward in each hand, lying on 
the front of the arms (fig. 19) ; that in the right hand is allowed to 





fall backward (fig. 20), and swings downward, forward to the ex- 
tent of the arm, and as high as the head (fig. 21) ; the moment this 
club begins to return from this point, in precisely the same direc- 



PHYSICAL TRAINING AND GYMNASTICS. 



675 



tion, to the front of the arm, that in the left hand is allowed to drop 
backward, and to perform the advancing portion of this course in 
the time that the other performs the returning portion, so that 
each is, at the same time, sw^inging in an opposite direction. 

6th. From either of the first positions now given, the clubs are, 
by a turn of the body and extension of the arms, thrown upward 
and laterally (fig. 22) ; make, at the extent of the arms, and in 
front of the figure, a circle in which they sweep downward by the 
feet and upward over the head (fig. 23), and fall in a more limited 
curve toward the side on which they began (fig. 24), in such a 
manner that the outer one forming a circle around the shoulder 
and the inner one round the head, (both passing swiftly through the 





24 



position in the last figure of the first exercise,) they return to the 
first position ; this is repeated to the other side ; and so on alter- 
nately. 

7th. Beginning from either first position, the body being turned 
laterally — for example, to the left — the club in the right hand is 
thrown upward in that direction at the full extent of the arm (fig. 
25), and makes the large circle in front and curve behind, as in the 
last exercise (fig. 26), while the club in the left hand makes, at the 
same time, a smaller circle in front of the head and behind the 
shoulders (figs. 25, 26, and 27), until crossing each other before 



676 



AMERICAN HOUSEHOLD BOOK OF MEDICmE. 



the head (rather on the right side), their movements are exactly 
reversed, the club in the right hand performing the small circle 
round the head, while that in the left performs the large one, and 
these continue to be repeated to each side alternately. 

8th. The clubs being in either first position, the body is turned 
to one side — the left, for example — and the clubs being thrown out 
in the same direction, make each, by a turn of the wrist, a circle 
tlu-ee times on the outer side of the outstretched arms (fig. 28) ; 
■when completing the third circle, the clubs, are thrown higher to 
the same side, sweeping together in the large circle in front, as in 
the second exercise, the body similarly turning to the right ; but, 




25 



26 



27 



instead of forming the smaller curve behind, both are thrown over 
the back (fig. 29) ; from this position the clubs are thrown in front, 
•which is now toward the opposite side, and the same movements 
are reversed ; and so it proceeds alternately to each side. 

9th. In this exercise, the clubs are reversed, both being pendent 
in front, but the ends of their handles being upward on the thumb 
sides of the hand. (Fig. 30.) The exercise consists chiefly in de- 
scribing with the ends of the clubs two circles placed obliquely to 
each other over the head. For this purpose, the club in the right 
hand is, in a sweep to that side, first elevated behind the head, and 



PHYSICAL TRAINING AND GYMNASTICS. 



677 



thence passing to the left (fig. 31), the front, the right (fig. 32) be- 
hind, (where its continuation is indicated in fig. 32, and completed 
in fig. 33,) thus forms its circle ; meanwhile the club in the left 





hand, commencing when that in the right was behind the head, 
has passed on the back of its circle to the right (fig. 32), while that 
in the right hand has passed on the front of its circle to the same 



678 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

side (fig. 32, the parts performed in both being marked by complete 
lines, and the parts to be done merely indicated) ; and they con- 
tinue, that in the right hand by the back, and that in the left hand 
by the front, toward the left side (fig. 33), and so on at pleasure, 
circling over the head. 

[Although but two-thirds of the body, viz., from the loins up- 
ward, are called into operation in this exercise, its importance 
must be estimated by the fact that they are precisely those requir- 
ing constant artificial practice, being naturally most exempted from 
exertion. As an adjunct to Training, there is nothing in the 
whole round of gymnastic performances that will be found of more 
essential service than this exercise with the Indian clubs. It de- 
mands but little muscular exertion, and calls chiefly upon that por- 
tion of the system which it finds in a state of comparative repose.] 

<* 

Locomotive Exercises. 

In walking, the position is nearly the same as that already de- 
scribed under the head Position. 

The head should be upright, easy, and capable of free motion, 
right, left, up, or down, without affecting the body. The body must 
be kept erect and square to the front, having the breast projected, 
and the stomach retracted, though not so as to injure either free- 
dom of respiration or ease of attitude. The shoulders should be 
kept moderately and equally back and low ; and the arms should 
hang unconstrainedly by the sides. The balance on the limbs must 
be perfect ; the knees straight, and the toes turned out as de- 
scribed ; the weight of the body should be thrown forward, as this 
facilitates progression. The military position in walking does not 
essentially differ from this, except in points that exclusively re- 
gard the soldier; as that the head be kept well up, and straight to 
the front, and the eyes not turned to the right or left; the arms and 
hands kept perfectly steady by the sides, and on no account suf- 
fered to move or vibrate, care, however, being taken that the hand 
does not cling to the thigh, or partake in the least degree of the 
movement of the limb. We may remark, however, that the volun- 
teer armies, both of the North and South, during the late gigantic 
war in this country, as good troops as were ever mustered, threw 
off very much of the old-fashioned, constrained style of movement, 
and adopted quite a free swing of the hands. 



PHYSICAL TRAINING AND GYMNASTICS 679 



The Balance Step. 

The object of this is to teach the free movement of the limbs, 
preserving, at the same time, perfect squareness of the shoulders, 
with the utmost steadiness of body; and no labor is spared to at- 
tain this first and most essential object, which forms, indeed, the 
very foundation of good walking. The instructor must be care- 
ful that a habit be not contracted of drooping or throwing back a 
shoulder at these motions, which are intended practically to show 
the true principles of walking, and that steadiness of body is com- 
patible with perfect freedom in the limbs. 

1. Without Gaining Ground. — To insure precision, the mili- 
tary words of command are prefixed. 

Caution — Balance step without gaining ground, commencing 
with the left foot. The left foot is brought gently forward with 
the toe at the proper angle to the left, the foot about three inches 
from the ground, the left heel in line wdth the toe of the right foot. 

Rear — when steady, the left foot is brought gently back (with- 
out a jerk), the left knee a little bent, the left toe brought close 
to the right heel. The left foot in this position will not be so flat 
as to the front, as the toe will be a little depressed. 

Front — When steady, the word Front will be given as above, and 
repeated to the rear three or four times. 

Halt — to prevent fatigue, the word Halt will be given, when the 
left foot, either advanced or to the rear, will be brought to the 
right. The instructor will afterward cause the balance to be 
made on the left foot, advancing and retiring the right in the same 
manner. 

2. Gaining Ground by the word "Forward." — Front — On 
the word Front, the left foot is brought gently to the front, without 
a jerk; the knee gradually straightened as the foot is brought 
forward, the toe turned out a little to the left, and remaining about 
three inches from the ground. This posture is continued for a 
few seconds only in the first instance, till practice gives steadiness 
in the position. 

Forward— On this word of command, the left foot is brought 
to the ground, at about thirty inches from heel to heel, while the 
right foot is raised at the same moment, and continues extended 
to the rear. The body remains upright, but inclining forward; the 
Lead erect, and neither turned to the right nor left. 



680 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Front — On the word Front, the right foot is brought forward, 
and so on. 

Walking. 

Of all exercises, this is the most simple and easy. The weight 
of the body rests on one foot, while the other is advanced; it is 
then thrown upon the advanced foot, while the other is brought 
forward, and so on in succession. In this mode of progression, 
the slowness and equal distribution of motion is such that many 
muscles are employed in a greater or less degree; each acts in 
unison with the rest, and the whole remains compact and united. 
Hence, the time of its movements may be quicker or slower, with- 
out deranging the union of the parts or the equilibrium of the 
whole. It is owing to these circumstances that walking displays 
so much of the character of the walker ; that it is light and gay 
in women and children, steady and grave in men and elderly per- 
sons, irregular in the nervous and irritable, measured in the af- 
fected and formal, brisk in the sanguine, heavy in the phlegmatic, 
and proud or humble, bold or timid, etc., in strict correspondence 
with individual character. 

The utility of walking exceeds that of all other modes of pro- 
gression. While the able pedestrian is independent of stage- 
coaches and hired horses, he alone fully enjoys the scenes through 
which he passes, and is free to dispose of his time as he pleases. 
To counterbalance these advantages, greater fatigue is doubtless 
attendant on walking ; but this fatigue is really the result of pre- 
vious inactivity ; for daily exercise, gradually increased, by render- 
ing walking more easy and agreeable, and inducing its more fre- 
quent practice, diminishes fatigue in such a degree that very great 
distances may be accomplished with pleasure, instead of painful 
exertion. 

Moderate walking exercises the most agreeable influence over 
all the functions. In relation to health, walking accelerates respi- 
ration, and circulation increases the temperature and cutaneous ex- 
halation, and excites appetite and healthful nutrition. Hence, as 
an anonymous wTiter observes, the true . pedestrian, after a walk 
of twenty miles, comes in to breakfast with freshness on his counte- 
nance, healthy blood coursing in every vein, and vigor in every 
limb, while the indolent and inactive man, having painfully crept 
over a mile or two, returns to a dinner which he can not digest. 



PHYSICAL TRAINING AND GYMNASTICS. 681 

In all individuals, walking is indispensably joined with the exer- 
cise of one or more of the external senses. It receives from the 
cerebral faculties a powerful influence, by which it is either accel- 
erated or prolonged. Walking upon soft, even ground, at a mod- 
erate pace, is an exercise that may be taken without inconYenience, 
and even with advantage, after a meal. It is adapted for conva^ 
lescents, who are not yet allowed to take stronger exercise. A firm, 
yet easy and graceful walk, is by no means common. There are 
few men wdio walk well if they have not learned to regulate their 
motions by the lessons of a master, and this instruction is still 
more necessary for ladies. Having now, therefore, taken a gen- 
eral view of the character and utility of walking, I subjoin some 
more particular remarks on the 

General Mechanism op Walking. — For the purpose of walk- 
ing, we first bear upon one leg the weight of the body, which 
pressed equally on both. The other leg is then raised, and the 
foot quits the ground by rising from the heel to the point. For 
that purpose, the leg must be bent upon the thigh, and the thigh 
upon the pelvis ; the foot is then carried straight forward, at a suf- 
ficient height to clear the ground without grazing it. To render it 
possible, however, to move this foot, the haunch, which rested with 
its weight upon the thigh, must turn forward and out. As soon 
as, by this movement, this foot has passed the other, it must be 
extended on the leg, and the leg upon the thigh, and in this man- 
ner, by the lengthening of the whole member, and without being 
drawn back, it reaches the ground at a distance in advance of the 
other foot, which is more considerable according to the length of 
the step, and it is placed so softly on the ground as not to jerk or 
shake the body in the slightest degree. As soon as the foot, which 
has been placed on the ground, becomes firm, the weight of the 
body is transported to the limb on that side, and the other foot, 
by a similar mechanism, is brought forward in its turn. In all 
walking, the most important circumstance is, that the body incline 
forward, and that the movement of the leg and thigh spring from 
the haunch, and be free and natural. Viewed in this way, the feet 
have been well compared to the spokes of a wheel, the weight of 
the body falling upon them alternately. 

This exercise puts in action the extensors and flexors of the 
thighs and legs, a great number of the muscles of the trunk, and 
more or less those of the shoulder, according to the rapidity of 



682 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

tlie pace, and the greater or less degree of projection communi- 
cated to the arm, which, in this exercise, acts as a balancer of the 
body, the motion being exactly the reverse of that of the corre- 
sponding leg. It draws the fluids more into the inferior than supe- 
rior members ; it gives but little strength to the latter. Walking 
may be performed in three different times — slow, moderate, or 
quick — which somewhat modify its action. 

The Slow Walk, or March. — In the march, the weight of the 
body is advanced from the heel to the instep, and the toes are 
turned out. This being done, one foot — the left, for instance — is 
advanced, with the knee straight and the toe inclined to the ground, 
which, without being drawn back, it touches before the heel, in 
such a manner, however, that the sole, at the conclusion of the 
step, is nearly parallel with the ground, which it next touches with 
its outer edge ; the right foot is then immediately raised from the 
inner edge of the toe, and similarly advanced, inclined, and brought 
to the ground ; and so on in succession. Thus, in the march, the 
toe externally first touches, and internally last leaves the ground ; 
and so marked is this tendency that, in the stage step, which is 
meant to be especially dignified — as the posterior foot acquires an 
awkward flexure when the weight has been thrown on the ante- 
rior — in order to correct this, the former is for an instant ex- 
tended, its toe even turned backivard and outward, and its tip 
internally alone rested on the ground, previous to its being, in its 
turn, advanced. Thus the toe's first touching and last leaving the 
ground is peculiarly marked in this grandest form of the march. 
This pace should be practiced until it can be firmly and gracefully 
performed. 

The Moderate and the Quick Pace. — These will be best un- 
derstood by a reference to the pace which we have just described, 
the principal difference betAveen them being as to the advance of 
the weight of the body, the turning out of the toes, and the part 
of the foot which first touches and last leaves the ground. We 
shall find that the times of these two paces require a further ad- 
vance of the .weight, and suffer successively less and less of turn- 
ing out the toes, and of this extended touching with the toe, and 
covering the ground with the foot. 

The Moderate Pace. — Here the weight of the body is ad- 
vanced from the heel to the ball of the foot; the toes are less 
turned out; and it is no longer the toe, but the ball of the foot, 



PHYSICAL TRAINING AND GYMNASTICS. 683 

wliich first touches and last leaves the ground; its outer edge, or 
the ball of the little toe, first breaking the descent of the foot, and 
its inner edge, or the ball of the great toe, last projecting the 
weight. Thus, in this step, less of the foot may be said actively 
to cover the ground; and this adoption of nearer and stronger 
points of support and action is essential to the increased quickness 
and exertion of the pace. 

The mechanism of this pace has not been sufficiently attended 
to. People pass from the march to the quick pace they know not 
how ; and hence all the awkwardness and embarrassment of their 
walk when their pace becomes moderate, and the misery they en- 
dure when this pace has to be performed by them, unaccompanied, 
up the middle of a long and well-lighted room, where the eyes of 
a brilliant assembly are exclusively directed to them. Let those 
who have felt this but attend to what we have here said ; the motion 
of the arms and of every other part depends on it. 

The Quick Pace. — IJere the weight of the body is advanced 
from the heel to the toes; the toes are least turned out; and still 
nearer and stronger points of support and action are chosen. The 
outer edge of the heel first touches the ground, and the sole of 
the foot projects the weight. 

These are essential to the increased quicknesss of this pace; and 
it is important to remark, as to all these paces, that the weight is 
successively more thrown forward, and the toes are successively 
less turned out. In the grandest form of the march, the toes, as 
we have seen, are, in the posterior foot, though but for a moment, 
even thrown backward ; in the moderate pace, they have an inter- 
mediate direction; and in the quick pace, they are thrown more 
directly forward. 

It is this direction of the toes, and still more the nearer and 
stronger points of support and action — namely, the heel and sole 
of the foot — which are essential to the quick pace so universally 
practiced, but which, together with the great inclination of the 
body, being ridiculously transferred to the moderate pace, make 
unfortunate people look so awkward, as we shall now explain. The 
time of the moderate pace is, as it were, filled up by the more com- 
plicated process of the step — by the gradual and easy breaking of 
the descent of the fctot on its outer edge, or the ball of the little 
toe, by the deliberate positing of the foot, by its equally gradual 
and easy projection from its inner edge, or the ball of the great 



684 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

toe. The quick pace, if its time be lengthened, has no such fill- 
ing up ; the man stumps at once down on his heel, and could rise 
instantly from his sole, but finds that, to fill up his time, he must 
pause an instant; he feels he shotld do something, and does not 
know what; his hands suiFer the same momentary paralysis as his 
feet ; he gradually becomes confused and embarrassed ; deeply 
sensible of this, he at last exhibits it externally ; a smile or titter 
arises, though people do not well know at what; but, in short, the 
man has walked like a clown, because the mechanism of his step 
has not filled up its time,- or answered its purpose. 

I trust that the mechanism and time of the three paces are here 
simply, clearly, and impressively described. The following is the 
more imperfect, but still useful, military description, with its words 
of command : 

Slow Step. — March. — On the word March, the left foot is car- 
ried thirty inches to the front, and, without being drawn back, is 
placed softly on the ground, so as not to Jerk or shake the body; 
seventy-five of these steps to be taken in a minute. (The recruit 
is ordered to be carefully trained, and thoroughly instructed in 
this step, as an essential foundation for arriving at accuracy in the 
paces of more celerity. This is the slowest step at which troops 
are to move.) 

Quick Step. — The cadence of the slow pace having become 
perfectly habitual, a quick time is next taught, which is 108 steps 
in a minute, each of thirty inches, making 270 feet in a minute. 

Quick, March. — The command Quick, March, being given with a 
pause between them, the word Quick is to be considered as a cau- 
tion, and the whole to remain perfectly steady. On the word 
March, the whole move ofi", conforming to the directions already 
given. (This pace is applied generally to all movements by large 
as well as small bodies of troops ; and, therefore, the recruit is 
trained and thoroughly instructed in this essential part of his 
duty.) 

Double March. — The directions for the march apply, in a great 
degree, to this step, which is 150 steps in a minute, each of thirty- 
six inches, making 450 feet in a minute. 

Double March. — On the word Double March, the whole step off 
together with the left feet, keeping the head 'erect and the shoul- 
ders square to the front ; the knees are a little bent ; the body is 
more advanced than in the other marches; the arms hang with 



PHYSICAL TRAINING AND GYMNASTICS. 685 

ease down the outside of the thighs. The person marching is care- 
fully habituated to the full pace of thirty-six inches, otherwise he 
gets into the habit of a short trot, which defeats the obvious advan- 
tages of this degree of march. In the army, great advantage at- 
tends the constant use of the plummet ; and the several lengtljs 
swinging the times of the different marches in a minute, are as 
follows : 



IN. HUN. 



Slow time . . 75 steps in a minute . . . 24,96 
Quick time . . 108 " " ... 12,03 

Double march . 150 " " ... 6,26 

A musket-ball, suspended by a string which is not subject to 
stretch, and on which are marked the different required lengths^ 
answers the above purpose, may be easily acquired, and is directed 
to be frequently compared with an accurate standard in the adju- 
tant's possession. The length of the plummet is to be measured 
from the point of suspension to the center of the ball. In prac- 
ticing all these paces, the pupils should also be accustomed to march 
upon a narrow plane, where there is room for only one foot, upon 
rough uneven ground, and on soft ground which yields to the foot. 

Walking exercises a greater influence over the economy when it 
takes place on inclined planes than on a flat surface. In ascend- 
ing, the effort is made in a direction directly opposed to the gen- 
eral tendency of heavy bodies ; the body is strongly bent, the upper 
part of the trunk in advance ; the action of the posterior and an- 
terior muscles of the thigh is considerable ; and circulation and 
respiration are speedily accelerated by the violence of the muscu- 
lar contractions. In descending, on the contrary, effort is requisite 
to keep up the body, which tends to obey the laws of gravitation ; 
and to moderate the tendency of gravity to project forward in the 
center, the body is throw^n back, the sacro-spinal mass and the 
posterior muscles of the neck are strongly contracted, the knees 
bent, and the steps much shorter. Men with long flat feet, and the 
heel bone little projecting, are bad walkers. 

A good walker will do six miles an hour, for one hour, on a good 
road. If in perfect training, he may even do twelve miles in two 
hours. Eighteen miles in three hours is a much more doubtful 
affair, though some are said to have achieved it. 

At the rate of five miles an hour, pedestrians of the first class 
will do forty miles in eight hours, and perhaps fifty in ten. At the 
rate of four miles an hour, a man may walk any length of time. 



686 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

« 

In tlie art of walking quickly, tlie circumstance, perhaps, most 
important is, to keep the knees somewhat bent and springy. 

RUNNINa. 

*' Running," says one of our gymnasiarchs, "only differs from 
walking by the rapidity of the movement." This is quite incor- 
rect. Running is precisely intermediate to walking and leaping ; 
and, in order to pass into it from walking, the motion must be 
changed. A series of leaps from each foot alternately must be 
performed, in order to constitute it ; the foot which is left behind 
quits the ground before the foot in advance is firmly fixed, so that 
the center of gravity remains uncertain in passing from one leg to 
the other, which forms a series of leaps, and renders a fall a com- 
mon occurrence. 

Position in Running. — The upper part of the body is slightly 
inclined forward ; the head slightly thrown backward, to counter- 
act the gravit^r forward ; the breast is freely projected ; the shoul- 
ders are steady, to give a fixed point to the auxiliary muscles of 
respiration ; the upper parts of the arms are kept near the sides ; 
the elbows are bent, and each forms an acute angle ; the hands 
are shut, with the nails turned inward ; and the whole arms move 
but slightly, in order that the muscles of respiration on the chest 
may be as little as possible disturbed, and follow only the impulse 
communicated by other parts. There exists, in fact, during the 
whole time of running, a strong and permanent contraction of the 
muscles of the shoulder and arm, w^hich, though very violent, is 
less serviceable to the extended movements than to keep the chest 
immoveable, toward which the arms are brought close, the flexors 
and adductors of which are especially contracted. 

Action in Running. — At every step, the knees are stretched 
out ; the legs kept as straight as possible ; the feet almost graze 
the ground ; the tread is neither with the mere balls of the toes, 
nor with the whole sole of the foot ; and the spring is made rapidly 
from one foot to the other, so that they pass each other with great 
velocity. 

.But the abdominal members are not the only ones in motion, 
although it is in them that the greatest development takes place. 
Throughout the whole time of running, a strong and permanent 
contraction of the muscles of the shoulder, arm, and forearm takes 



PHYSICAL TRAINING AND GYMNASTICS. 687 

place ; this, though very violent, is less for the purpose of aiding 
motion than of preserving the immobihty of the thorax, which is 
pressed upon the whole thoracic member, whose flexors and adduc- 
tors are Strongly contracted. The degree of velocity, however, 
must be proportioned to the length of the steps. Too slow and 
long, as well as too quick and short, steps maybe equally injurious. 

Respiration. — Speed, and, still more, duration in running, are in 
proportion to the development of the lungs, and consequently the 
volume of oxygen and blood which they can combine in their par- 
enchyma at each respiratory movement. Thus, of two men, one 
having the abdominal members developed, and the other, possess- 
ing good lungs, the former will run with the greatest speed for a 
short distance, but, if the distance be considerable, he will soon be 
gained upon by the latter. A runner, after performing a certain 
space, is seized with a difficulty of breathing, long before the repe- 
tition of the contractions has produced fatigue in the abdominal 
members. To excel, therefore, in running, requires, like walking 
and dancing, a peculiar exercise. As the muscular contractions 
depend, for their principle of excitement, on the respiration, the 
chest should be firmly fixed, so as both to facilitate this and to 
serve as a point of support for the efforts of the lower members. 
The best runners are those who have the best wind, and keep the 
breast dilated for the longest time. 

During the whole time of running, long inspirations and slow 
expirations are of the greatest importance ; and young persons can 
not be too early accustomed to them. To facilitate respiration to- 
ward the end of the race, the upper part of the body may be leant 
a little forward. Running should cease as soon as the breath be- 
comes very short and a strong perspiration takes place. 

Moderate Running. — This is performed gently and in equal 
time, and may be extended to a considerable space. In practicing 
this pace, it is necessary to fix the distance to be run; and this 
should always be proportioned to the age and strength of the run- 
ners. This exercise, more than all others, requires to be pro- 
ceeded with in a progressive manner. If, at the first trial, you 
run too fast or too long a time, it may produce spitting of blood 
and headache, or aneurisms of the heart and principal vessels, 
especially if the weather be dry and cold. 

A moderately cool day may, accordingly, be chosen, a distance 
of three hundred feet measured^ and the runners placed in a line 



688 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

at one end. Thej may then start, trot at the rate of about seven 
feet in a second to the opposite end, turn, and continue until they 
reach the spot whence they started. FrequenJ; repetition of this 
is sufficient at first. Afterward they may run over this Space two, 
three, or four times without stopping ; and the exercise may then 
be limited to this. It may, on subsequent days, be extended to 
five, six, and seven times the distance. 

Fatigue is then generally quite removed ; and the run may either 
be continued further, or the runners, if neither heated nor winded, 
may accelerate their pace. They may next attempt a mile in ten 
minutes ; ^nd repeat this, till, being gradually less and less heated, 
they can either extend the distance or diminish the time in any 
measured proportion. 

Rapid RuNNma. — This is best applied to a short space in a lit- 
tle time. Three hundred feet, upon an open plain, will not gen- 
erally be found too great. At each end of this, a cross line may 
be drawn, and the runners may arrange themselves on one line, 
while the umpire is placed at the other. On the latter giving the 
signal, the running commences, and he who first passes him gains 
the race. It is extremely useful always to run beyond the line at 
a gentler pace, as it gradually lowers the actions of the respiratory 
and circulating systems. 

Running is more easy on a level surface, but should be prac- 
ticed on ground of every variety — upon long, square, and circular 
plots of ground. The pupils should be accustomed to turn promptly 
out of the direct line — a faculty not possessed by animals, and 
exceedingly useful when pursued. They should also run up hill, 
and particularly down, as it is dangerous unless frequently prac- 
ticed. 

Feats in Running. — The practice of running may be carried 
to a greater degree of perfection. 

A quarter of a mile in a minute is good running; and a mile in 
four minutes, at four starts, is excellent. 

The mile was, perhaps, never run in four minutes, but it has 
been done in four minutes and a half. 

A mile in five minutes is good running. Two miles in ten min- 
utes is oftener failed in than accomplished. Four miles in twenty 
minutes is said to puzzle the cleverest. 

Ten miles an hour is done by all the best runners. Fifteen miles 
in an hour and a half has never, perhaps, been done. 



PHYSICAL TRAINING AND GYMNASTICS. 689 

Effects of Running. — In running, the mass of our organs is 
.agitated by violent and constant shocks, which succeed with rapid- 
ity; but the abdominal members are not the only ones in motion, 
although they are those in which the development is most consid- 
erable. Running develops not only the abdominal members, but 
has a strong influence upon the respiratory parts. This exercise 
is particularly suited to young persons, especially those of a lym- 
phatic temperament. It should not, however, be practiced after 
meals. 

LBApma. 

Leaping consists principally in the sudden straightening of the 
articulations, performed by a strong and instantaneous contraction 
of the extensors, by which the body is rapidly projected from the 
ground. 

The leaping-stand consists of two moveable posts, above six feet 
high, having, above the second foot from the ground, holes bored 
through them, at the distance of an inch from each other ; two iron 
pins to be placed in the hole at any height; a cord, at least ten 
feet long, passed over these pins, and kept straight by two sand- 
bags at its ends, and weights upon the feet of the posts, to prevent 
them from falling. The leap over the cord is made from the side 
of the stand toward which the heads of the pegs are turned; so 
that, if the feet should touch the cord, it will easily and instantly 
fall. 

In all kinds of leaping, it is of great importance to draw in and 
retain the breath at the moment of the greatest effort, as it gives 
the chest more solidity to support the rest of the members, impels 
the blood into the muscular parts, and increases their strength. 
The hands, also, should be shut, and the arms pendent. The ex- 
tent of the leap in height, or horizontally, is proportioned to the 
power employed and the practice acquired. As it is performed 
with facility only in proportion to the strength exerted, and the 
elasticity and suppleness of the articulations and muscles of the 
lower extremities, much exercise is necessary to attain that degree 
of perfection which lessens all obstacles, and supplies the means 
of clearing them without danger. Lightness and firmness are the 
qualities necessary for leaping; every thing should be done to ac- 
quire these two qualifications, for without them leaping is neither 
graceful nor safe. 
44 



690 AMEEICAN HOUSEHOLD BOOK OF MEDICINE. 

The High Leap without a Run. — In this the legs and feet 
are closed; the knees are bent till the calves nearly touch the 
thighs ; the upper part of the body, kept straight, is inclined a lit- 
tle forward; and the arms thrown in the direction of the leap, 
which increases the impulse, preserves the balance, and may be 
useful in a fall. 

The vertebral column, and consequently the whole of the trunk, 
being thus bent forward, a strong contraction of the muscles pre- 
serves this bending till the moment when the leap takes place ; 
then, by sudden contraction of the extensors, the body stretches 
out like a bow when the string breaks, is thus jerked forward, and 
remains suspended a longer or shorter time in the air. 

In descending, the person should be rather inclined forward; 
and the fall should take place on the forepart of the feet, bending 
the knees and haunches, to deaden the shock and descent ; for the 
direct descent in this leap, if not thus broken, would send its shock 
from the heels to the spine and head, and might occasion injury. 
To perpendicularity in this leap, should be added lightness, so that 
scarcely any noise from the leap should be heard. 

This leap, without a run, may be practiced at the height, 

1. Of the knees. 

2. Of the middle of the thighs. 
8. Of the hips. 

4. Of the lower ribs. 

The High Leap — With a Bun. — The run preceding the leap 
should never exceed ten paces, the distance between the point of 
springing and the cord being equal to half the cord's height from 
the ground. The view of the leaper should be directed first to the 
spot whence he is to spring ; and, the moment he has reached that 
to the cord, accustoming himself to spring from either foot, and 
from both feet. 

The instant the spring is made, or (if it be made with one foot) 
immediately after, the feet should be closed, and the knees drawn 
forcibly toward the chin. Throughout, flexibility and skill, not 
violent exertion, should be displayed. This leap, with a run, may 
be practiced at the height, 

1. Of the hips. 

2. Of the lower ribs. 

3. Of the pit of the stomach. 

4. Of the breast. 



PHYSICAL TRAINING AND GYMNASTICS. 691 

5. Of the chin. 

6. Of the eyes. 

7. Of the crown of the head. 

Feats in Sigh Leaping. — A good high leaper will clear five feet; 
a first-rate one, five and a-half ; and an extraordinary one, six feet. 
A case is on record of one man having cleared an extended cord 
at the height of fourteen feet, while another, it is said, jumped to 
the height of seventeen feet, which was three times the height of 
his own body.* 

The Long Leap — Without a Itun. — This is generally performed 
upon straight firm ground, on which there are marks, or parallel 
lines, at equal distances. The first of these lines is the place to 
leap from. The leapers succeed each other, and clear a greater 
number of lines according to their strength and skill. Here the 
feet are closed ; the whole weight rests upon the balls of the toes, 
and the body is inclined forward. Both arms are then swung for- 
ward, backward, then drawn strongly forward, and, at the same 
instant, the limbs, having been bent, are extended with the utmost 
possible force. 

In performing this leap, the hands and body must be bent for- 
ward, especially at the end of the movement, when the leaper 
alights. On level ground, twelve feet is a good standing leap, and 
fourteen is one of comparatively rare occurrence. 

The Long Leap — With a Run. — This leap is best executed with 
a run ; and we have, therefore, dwelt less upon the former. Here, 
also, the body must be inclined forward. 

The run should be made over a piece of firm, and not slippery 
ground, to the extent of ten, fifteen, or twenty paces ; should con- 
sist of small steps, increasing in quickness as they approach the 
point of springing ; and these should be so calculated as to bring 
upon the point that foot with which the leaper is accustomed to 
spring. The spring, as here implied, should be performed with 
one foot, and the arms thrown forcibly toward the place proposed 
to be reached. The height as well as the length of the leap must 
be calculated ; for the leap is shortened by not springing a proper 
height. 

In the descent, the feet are closed, the knees bent, the upper 
part of the body inclined forward, and the toes first touch the 

'■ The author means, with the aid of a spring-board. 



692 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

ground, at which moment, a light spring, and afterward some short 
steps are made, in order to avoid any sudden check. In a much 
extended leap, however, alighting on the toes is impossible. A 
sort of horizontal swing is then achieved, by which the leaper's 
head is little higher than his feet, and his whole figure is almost 
parallel with the ground ; and, in this case, to alight on the toes 
is impossible. Care must here be taken not to throw the feet so 
much forward as to cause the leaper to fall backward at the mo- 
ment of descent. The ground must be cleared, or the leap is im- 
perfect and unfair. 

This leap may be practiced at, 

1. Double the length of the body. 

2. Twice and a half that length. 

3. Three times that length. 

Feats in Long Leaping. — On level ground, twenty feet is a first- 
rate leap ; twenty-one is extraordinary ; and twenty-two is very 
rarely accomplished. With a run and a leap, on a slightly in- 
clined plane, twenty-three feet is the longest leap which I have 
seen recorded. 

Of the various kinds of leaps, the first or simple leap, which is 
produced principally by the extension of the abdominal members, 
which impel the body either straight upward, in the vertical leap, 
or obliquely upward and forward, in the horizontal or rather para- 
bolic leap, requires, in addition to the contraction of the abdominal 
members, especially if the leap be executed with the feet close to- 
gether, a violent action of the muscles of the abdomen, upper parts 
of the back, anterior parts of the loins, and of the thorax and 
shoulders. 

The Deep Leap. — This may be made either with or without the 
hands. In either way, to avoid the shock, the body must be kept 
in a bent position, and the fall be upon the balls of the toes. 
When the hands are used, the leaper places them in front of the 
feet ; and during the descent, the weight of the body is checked 
by the former, and passes in a diminished state to the latter ; so 
that the shock is obviated. 

A flight of steps serves the purpose of this exercise. The 
leaper ascends a certain number; leaps from the side; gradually 
increases the number ; and, by practicing progressively higher, 
finds it easy to leap from heights which at first appalled him. He 
afterward combines the long and deep leaps. For this purpose, a 



PHYSICAL TRAINING AND GYMNASTICS. 693 

rivulet, which has one bank high and the opposite one low, is very 
favorable. Children can easily take a leap of nine feet in descend- 
ing. 

The Deep Leap Backward, from a Rest on the Hands. — 
This exercise is first performed from platforms of various heights, " 
and from walls of various elevations. The object is to lessen the 
shock that the legs and body experience in reaching the ground at 
a depth of more than six or seven feet, and to diminish the distance, 
if possible, at the same time that it diminishes the violence and 
velocity of the fall. All this is easily managed by observing the 
following rules : 

Suppose the pupil placed upon a platform of four or six feet in 
height, he must first examine the place he is about to leap to, so 
as to select the most favorable part, free from stones and other 
obstacles. He will then approach the extremity of the platform, 
with his back toward it, and bend his body. Having taken up 
this position securely, he will lean his head a little forward, raise 
his toes from the platform, and remain for an instant supported by 
the arms. The body then begins to extend, and the legs to lengthen 
downward and backward ; the arms follow this movement, bend, 
and support the body by the hands, which have a secure resting- 
place on the edge of the platform. This descending movement is 
executed as slowly as possible ; the arms stretch out to their ut- 
most length, till the body is sustained by the last phalanx of the 
fingers, or touches the ground with the feet. If it does not reach 
the ground, the pupil drops gently down on the tips of his toes, 
bends himself, and recovers his upright position. 

There is another mode of descending, when the last resting- 
place for the hands is the top of a counterfort, or prop on a wall 
without a counterfort. This consists in seizing the last hold with 
the right hand for instance, and in hanging firmly by that hand, 
while the left, being at liberty, is lowered and pushes back the body 
from the projecting stones in the walls, to prevent injury in the 
descent. The impulse thus given is, however, very trifling, and 
solely to avoid hurt, without increasing the violence of the fall, 
which ought to be facilitated on reaching the ground by the rules 
already given. By these means, the height of a wall is relatively 
diminished, for a man who hangs suspended by his arms, has six 
feet less to drop than he who has his feet where he might put his 
hands. 



694 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

The down leap, unless gradually practiced, may produce rup- 
tures of the diaphragm. When, however, the elevation from which 
the leap is taken is gradually increased, the eye becomes accus- 
tomed to measure the most extensive distances fearlessly, at the 
same time that by practice the abdominal members learn to bend 
properly under the weight of the trunk, and thereby preserve the 
organs contained in it from serious injuries. In this kind of leap, 
the shocks will be diminished by retaining the air in the chest, 
which may be done by closing the glottis. 

Persons who have long toes, powerful calves, and prominent 
heels, are the best adapted for leaping. 

YAULTma. 

In vaulting, by a spring of the feet, the body is raised, and by 
leaning the hands upon a fixed object, it at the same time receives, 
in oblique vaulting, a swing which facilitates the action. As the 
inclination thus given to the body depends not merely on the feet, 
but on the hands, we have the power to guide the body in any 
direction. 

This exercise is conveniently practiced on the vaulting bar, 
which rests upon two or three posts. It may be performed with 
or without running. The beginner may at first be allowed a run 
of a few paces, ending in a preparatory spring ; and he may after- 
ward be allowed only a spring. 

Oblique Vaulting. — To mount, the vaulter must place him- 
self in front of the bar, make a preparatory spring with the feet 
close, fix at that moment both hands upon the bar, heave him- 
self up, and swing the right leg over. The body, supported by 
the hands, may then easily descend into the riding position. To 
dismount, the vaulter, supported by the hands, must extend the 
feet, make a little swing forward, and a greater one backward, so 
as to heave both feet behind over the bar, and spring to the ground 
with them close. 

To do this he must first clearly define to himself the place where 
he intends to fall. Then, having placed both hands upon the bar, 
he should first bend and then extend the joints, so as to raise the 
body with all his strength, and throw his legs, kept close, high 
over the bar. (Fig. 34.) When the right hand (if he vault to the 
right) quits the bar, the left remains, the feet reach the ground on 



PHYSICAL TRAINING AND GYMNASTICS. 



695 



tlie opposite side, and he falls on both feet, with the knees pro- 
jected, and the hands ready, if necessary, to break the fall. 

In vaulting to the right, the left foot passes in the space which 
was between both the hands, the right hand quits the bar, and the 
left guides the body in the descent. In vaulting to the left, the* 
right foot passes in the space, which was between both hands, the 
left hand quits the bar, and the right guides the body in its de- 
scent. As, however, it is difficult for beginners to vault either 
way, this is not to be attempted until after sufficient practice in the 
way which may be easiest. The vaulter may then, with a prepar- 
atory spring, try the following heights : 

1. That of the pit of the stomach. 

2. That of a middling-sized horse. 

3. His own height or more. 

Straight-forward Vaulting. 
For this purpose, both hands must 
be placed at such distance on the 
bar as to give room for the feet 
between them; the body should 
be forcibly raised, the knees drawn 
up toward the breast, and the feet 
brought between the hands, with- 
out moving them from their place. 
(Fig. 35.) This exercise should 
be practiced until it can be done 
easily. 

This straight-forward vault may 
have three different terminations. 
When the feet are in the space 
between the hands, the vaulter 
may stand upright. He may pass 
his feet to the opposite side, while 
he seats himself. He may con- 
tinue the leap over the seat, 
through the arms, letting both 
hands go at once after the legs 
have passed. 




696 AMEKICAN HOUSEHOLD BOOK OF MEDICINE. 



Leaping with a Pole. 

This is a union of leaping and vaulting, in which the vaulter^ 
instead of supporting himself upon a fixed object, carries with him 
a pole^ which he applies to w^hatever spot he chooses. In sup- 
porting the body by a pole during the leap, a great deal also de- 
pends upon balancing, as well as on the strength of the arms and 
legs. 

The High Leap with a Pole.— The pole prescribed for this 
exercise is the planed stem of a straight-grown fir, from seven" to 
ten feet long, and about two inches thick at the bottom. Such a 
pole naturally diminishes toward the top ; and it is better to plane 
ofi' the lower end a little. Care must be taken that it be sufficiently 
strong; such as make a crackling noise during the leap should be 
immediately thrown aside. 

The learner, supposed to be already expert in leaping and vault- 
ing, may at first place himself before a small ditch, with a poloj 
which he holds in such a manner, that the right hand be about the 
height of the head, and the left about that of the hips, and in this 
case he must fix it in the ditch. He must then, by making a 
spring with his left foot, endeavor to rest the weight of his body 
upon the pole, and, thus supported, swing himself to the opposite 
bank. In this swing, he passes his body by the right of the pole, 
making, at the same time, a turn, so that, at the descent, his face 
is directed to the place whence he leaped. The faults usually com- 
mitted by the beginner, consist in his trusting to the pole the 
whole weight of the body, and in losing the necessary purchase by 
keeping at too great a distance from it. 

This leap can not be made with proper force and facility unless 
the fixing of the pole in the ground and the spring are made ex- 
actly at the same moment. To acquire this, the learner should 
place himself at the distance of a moderate pace in front of the 
ditch, raise the left foot and the pole together, plant both together, 
the former in the spot whence he intends making the spring, and 
the latter in the ditch, then instantly swing himself round the 
pole to the opposite bank. As soon as he can easily take the 
proper position and balance, he may endeavor to swing his legs 
higher; and in proportion as he becomes more expert, he must 
place his hands higher up the pole, in order to have a greater 
swing. He must afterward make a previous run of two, three, 



PHYSICAL TRAINING AND GYMNASTICS. 697 

or four paces, gradually increasing in velocity, and always taking 
care that the springing foot and the pole come to the ground at 
the same moment. When this difficulty is overcome, he may prac- 
tice the exercise over the leaping-stand. 

In leaping over the cord, the learner must take the pole in both 
hands ; make a rather quick run ; conclude this with the spring, 
and planting the pole at the same moment ; raise rapidly his whole 
body, by means of this spring and a powerful support on the pole, 
and swing over the cord ; turning his body so that, at the descent, 
his face is directed to the place whence he sprang. This is a gen- 
eral description of the high leap ; but it is necessary to explain the 
parts into which it may be divided, as follows : 

1. In the handling the pole, it is immaterial, as to the lower 
hand, whether the thumb or the little finger be uppermost ; the 
upper hand must have the thumb upward. The position of the 
upper hand is regulated by that of the lower one ; as this advances 
higher up, the former must be proportionally raised. The lower 
hand then must be placed at a- height proportionate to that of the 
leap; thus, if the latter be six feet, the lower hand must be at 
least from five and a half to six feet from the lower end of the pole. 
The leaper is, after a little practice, enabled to seize the pole in 
the proper way, from a mere glance at the leap. 

2. The preparatory run of from twelve to fifteen paces is accel- 
erated as the leaper approaches the cord. Upon this run princi- 
pally depend the facility and the success of the leap. As the spring 
can take place only with one foot, and as this must arrive correctly 
at the springing place, it is necessary that the order of the steps 
should be arranged so as to effect this object. If the leaper should 
be obliged to correct himself by making a few steps, either longer 
or shorter, just before making the spring, the leap is rendered dif- 
ficult. 

3. The fixing of the pole in the ground and the spring must take 
place at the same instant, because by that means the upper and 
lower members operate together, no power is lost, and the swing 
is performed with great facility. The place of the pole, however, 
varies with the height of the leaps; in leaps of about four feet, the 
distance of one foot from the cord is sufficient; in higher leaps, 
it should be from one and a half to two feet. The best plan is to 
have a small pit dug in front of the cord, and to remove the stand 
from it, as the height of the leap increases ; or the stand may re- 



698 AMERICAN HOUSEHOLD BOOK OF MEDICINE, 

main at a foot and a half from the pit, and the learner be taughfc 
to make all the leaps from it. The spring is made with one foot, 
at the distance of two, three, four, or five feet from the plant of 
the pole. If the leapei' keep the left hand lowest, he must spring 
with the left foot, and vice versa. 

4. The swing upward is effected by the force of the spring, the 
support of the lower, and the pull of the upper hand ; but princi- 
pally by the propulsion of the run, which, being suddenly modified 
by the fixing of the pole, has its horizontal direction changed into 
a slanting ascent, and 'carries the body of the leaper over the cord. 
The leaper must carefully observe that the spring of the foot and 
the plant of the pole be in the direction of the preparatory run. 

5. The turning of the body during the swinging upward is nec- 
essary. When the leaper is going to spring, he has his face turned 
toward the object of the leap; but, as his feet swing, his body 
turns round the pole. When his feet have passed over the other 
side of the cord, the head is still considerably on this side. Speedily, 
the middle of his body is on the other side of the cord, and he be- 
gins the descent. It would be impossible to descend in this posi- 
tion otherwise than with his face directed to the place where the 
leap was commenced. 

6. The quitting of the pole, during the leap, is effected by giv- 
ing it a push with one hand, at the moment of greatest height, and 
this causes it to fall on the inner side of the cord. 

7. The carrying of the pole over the cord is more difficult. The 
leaper must then raise the pole a little from the ground at the mo- 
ment of beginning the descent, and instantly elevate the lower part 
of it with the lowest hand, and depress the upper part with the other, 
the consequence being that, at the descent, the lower end of the 
pole will point upward, and the upper end downward. This should 
be practiced first in low leaps. 

8. The descent depends entirely upon the manner in which the 
leap was made ; if the leap be perfect, the descent will be so. The 
usual fault in descending is, that the leaper, having passed the cord, 
falls to the ground almost perpendicularly, instead of obliquely. 
In the annexed figure, a is the place whence the spring is made, 
e the section of the cord, b the position of the leaper over it, d his 
right, and e his wrong descent. The latter is faulty, because it 
throws him so much out of balance that, in order not to fall back- 
ward, he must run backward to d. If, on the contrary, he de- 




PHYSICAL TRAINING AND GYMNASTICS. 699 

scends in proper balance to the ground, he moves not an inch from 
the spot where his feet alight ; and this complete rest following the 
descent is the sign of a perfect leap. 
The descent, as already explained, 
must take place upon the balls of the 
toes, and with a sinking of the knees. 
But many learn to swing the legs so 
well as to raise them, during the high- 
est part of the leap, considerably above 
the head. Order of exercises in the high leap, to be very grad- 
ually attempted : 

1. The height of the hip. 

2. That of the pit of the stomach. 

3. That of the chin. 

4. That of the crown of the head. 

5. That of the points of the fingers; that is, as high as the latter 
can reach. 

In performing these leaps, the pole is parted with. As many 
more may form a repetition of the preceding, with this difference, 
that the leaper carries the pole over with him. A similar number 
may repeat the first, except that the leaper, between the spring 
and descent, makes a complete turn round the pole, so as again" to 
bring his face in the direction of the leap. This enlarged turn is 
rendered easier by leaping a little higher than the cord requires. 

The Long Leap with a Pole. — This leap is the most useful, 
being applicable almost every- where ; and particularly in a coun- 
try intersected with small rivers, ditches, etc. It should be first 
practiced over a ditch, about three feet deep, eight feet broad at 
one. end, and about twenty-one feet at the other, and of any con- 
venient length. In this exercise, the pole should be rather stronger 
and longer than in the preceding one, depending, however, on the 
length of the leap, and the height of the bank it is made from. 

The handling of the pole is the same as in the high leap. The 
preparatory run is rapid, in proportion to the length of the leap. 
The spring takes place as in the preceding exercise. The swing 
is also the same, except that the curve of the leap is wider. The 
turning of the body may likewise be similar, but it is convenient 
to make only a quarter turn. In the descent the hand presses 
more upon the pole, and the feet are stretched out to reach the 
opposite bank, in which the leaper is descending. Another method 



700 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

of leaping a river is to force the body up so high by the pressure 
of the hands (of which one rests upon the end of the pole, or very 
near it), as to swing over the top of the pole, and allow it to pass 
between the legs when descending. Try the following : 

1. The leap of two lengths of the body. .^ 

2. That of three lengths of the body. 
8. That of four lengths of the body. 

4. Persons of equal strength try to outleap one another. 

The lengths of 18, 22, and 24 feet are frequently done by prac- 
tical leapers. 

The Deep Leap with a Pole.— Here neither the preparatory 
run nor the spring occur; there is nothing which requires the ex- 
ertion of the lower members. The use of the hands and arms, 
however, is peculiarly requisite, as well as a little of the art of 
balancing. The leaper fixes the pole, at a convenient distance 
from the place where he stands, in a chasm, ditch, or river, hav- 
ing one bank high, and the opposite one low. Seizing it with both 
hands in the usual way, he slips along it lower and lower; the 
whole weight of his body at last resting upon it. Thus, if the 
depth is considerable, as two lengths of the body, he may slide so 
far down upon it that his head appears slanting downward. In 
this position, he makes a slight push against the bank, or merely 
quits it, with his feet, which he swings by the side of the pole to 
the opposite bank. Here, also, the descent is performed upon the 
balls of the toes, with bending of the knees. The principal ad- 
vantage in this leap lies in the art of supporting the body, with- 
out tottering ; and, for this purpose, it is absolutely necessary that 
the feet should be stretched out far from each other, in an angular 
form ; otherwise the balance might be lost. The best way of prac- 
ticing this, in an exercise ground, is by a flight of steps. 

To the exercise of the abdominal members, these leaps unite a 
strong action of the muscles of the thorax, arms, and forearms, 
and even of those of the palms of the hand. The body is only 
half impelled by the abdominal members ; but this impulse is ren- 
dered complete by considerable eifort on the part of the thoracic 
members. The latter, in the vertical leap, being supported by the 
narrow and moveable base afforded by the pole, assist greatly in 
raising the body, and even keep it a moment suspended for the legs 
to pass over (if the object to be cleared is very high) before it al- 
lows the body to obey the force of gravity which carries it down. 



PHYSICAL TRAINING AND GYMNASTICS. 701 

This exercise communicates what is termed great lightness to the 
body, and great suppleness — that is to say, great relative strength 
of the abdominal members — and it also develops the superior mem- 
bers. It is good for lymphatic temperaments and young persons, 
but it should not be indulged in immediately after meals. It may; 
occasion accidents of the brain and spinal marrow, unless all the 
articulations are bent on returning to the ground. 

Climbing. 

Climbing is the art of transporting the body in any direction, 
by the aid, in general, both of the hands and feet. The climbing- 
stand consists of two strong poles, about fifteen feet high, and 
from fifteen to twenty-five feet distant, which are firmly fixed in 
the ground, and support a beam strongly fastened to them. One 
pole is two inches and a half in diameter; the other, which serves 
as a mast, should be considerably thicker; and both serve the pur- 
pose of climbing. To the beam are attached other implements of 
climbing, viz. : a ladder, an inclined board, a mast, an inclined pole, 
a horizontal bar, a rope ladder, an upright, an inclined and a level 
rope. 

Kinds of Climbing. — Climbing on fixed bodies should first be 
practiced. 

The Ladder. — Exercises on the ladder may be practiced in the 
following ways : 

1. By ascending and descending as usual. 

2. With one hand, carrying something in the other 

3. Without using the hands. 

4. Passing another on the front of the ladder, or swinging to 
the back, to let another pass. 

The Inclined Board. — This should be rather rough, about two 
feet broad, and two inches thick. To climb it, it is necessary to 
seize both sides with the hands, and to place the feet flat in the 
middle, the inclination of the board being diminished with the prog- 
ress of the pupil. 

At first, it may form with the ground an angle of about thirty 
degrees; and the climber should not go more than half-way up. 
This angle may gradually be augmented to a right angle, or the 
direction of the board may be made perpendicular. When the 
board is thus little or not at all inclined, the body must be much 



702 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

curved inward, and the legs thrust up, so that the higher one is 
nearly even with the hand. In descending, small and quick steps 
are necessary. 

The Upright Pole. — The upright pole should be about two 
inches and a half in diameter, perfectly smooth and free from 
splinters. 

The position of the climber is such as that nothing touches the 
pole except the feet, legs, knees, and hands. He grasps as high 
as possible with both hands, raises himself by bending the body 
and drawing his legs up the pole, holds fast by them, extends the 
body, again grasps higher up with his hands,- and continues the 
same use of the legs and arms. The descent is performed by 
sliding down with the legs, and scarcely touching with the hands. 

The Mast. — This is more difficult, as it can not be grasped with 
the hands, and it consequently should not be practiced until the 
climber is expert in the previous exercises. The position of the 
legs is the same as for the pole ; but, instead of grasping the mast, 
the climber lays hold of his left arm with his right hand, or the 
reverse, and clings to the mast with the whole body. 

The Slant Pole. — This must be at least three inches thick ; and 
as, in this exercise, the hands bear more of the weight than in 
climbing the upright pole, it should not be attempted until expert- 
ness in the other is acquired. 

The Horizontal, or Slightly Inclined Bar. — This may be about two 
inches wide at top, from ten to fifteen long, and supported by two 
posts, respectively six and seven feet high. The climber must 
grasp with both hands as high a part of the bar as he can reach, 
and, with arms extended, support his own weight as long as pos- 
sible. He must next endeavor to bend the elbows so much that 
one shoulder remains close under the bar ; or he may place both 
hands on the same side, and draw himself up so far as to see over 
it, keeping the legs and feet close and extended. 

He may then hang with his hands fixed on both sides, near to 
each other, having the elbows much bent, the upper parts of the 
arms close to the body, and one shoulder close under the bar; 
may lower the head backward, and may, at the same time, raise 
the feet to touch each other over the bar. In the last position, he 
may move the hands one before the other, forward or backward, 
and may either slide the feet along the bar, or alternately change 
them like the hands, and retain a similar hold. 



PHYSICAL TRAIXIXG AND GYMXASTICS. 703 

Hanging also by the hands alone, he moves them either forward 
or backward, keeping the arms firm, and the feet close and ex- 
tended. Or he may place himself in front of the bar, hanging by 
both hands, and move laterally. Being likewise in front of the 
bar, with his hands resting upon it, he may move along the b^r 
either to the right or left. In this position, the climber may en- 
deavor to sit upon the bar, for instance, on the right side, by taking 
hold with the right knee-joint, grasping firmly with the right hand, 
and bringing the left armpit over the bar. The riding position is 
thus easily obtained. From the riding position, he may, by sup- 
porting himself with one thigh, turn toward the front of the bar, 
allowing the leg of the other side to hang down ; and he may then 
very easily move along the bar sideways, by raising his body with 
his hands placed laterally on the bar. 

The Rope Ladder. — This should have several run dies to spread 
it out, and ought, in all respects, to be so constructed as not to 
twist and entangle. The only difficulty here is, that, as it hangs 
perpendicularly, and is flexible, its steps are liable to be pushed 
forward, and in that case the body is thrown into an oblique posi- 
tion, and the whole weight falls on the hands. To prevent this, 
the climber must keep the body stretched out and upright. 

Tlie Upright Rope. — In this exercise, the securing the rope may 
be effected in various ways. In the first method, the hands and 
feet alone are employed. The feet are crossed; the rope passes 
between them, and is held fast by their pressure ; the hands then 
grasp higher ; the feet are drawn up, they are again applied to 
the rope, and the same process is repeated. In the second, which 
is the sailor's method, the rope passes from the hands, generally 
along the right thigh, just above the knee, winds round the inside 
of the thigh, under the knee-joint, over the outside of the leg, and 
across the instep, whence it hangs loose ; and the climber, by tread- 
ing with the left foot upon that part of the rope where it crosses 
the right one, is firmly supported. This mode of climbing requires 
the right leg and foot to be so managed that the rope keeps its 
proper winding whenever it is quitted by the left foot. In descend- 
ing, to prevent injury, the hands must be lowered alternately. 

To rest upon the upright rope, the climber must swing the right 
foot round the rope, so as to wind it three or four times round the 
leg, must turn it, by means of the left foot, once or twice round the 
right one, of which the toes are to be bent upward, and must tread 



704 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

firmly with the left foot upon the last winding. Or, to obtain a 
more perfect rest, he may lower his hands along the rope, hold 
with the right hand, stoop, grasp with the left the part of the rope 
below^ the feet, raise it and himself again, and wind it round his 
shoulders, etc., until he is firmly supported. 

The Oblique Hope. — The climber must fix himself to the rope, 
and advance the hands along it, as already directed. The feet may 
move along the rope alternately ; or one leg, hanging over the rope, 
may slide along it; or, which is best, the sole of the foot may be 
laid upon the rope, and the other leg across its instep, so that the 
friction is not felt. 

The Level Rope. — This may have its ends fastened to posts of 
equal heights, and the same exercises may be performed upon it. 

Climbing Trees. — In attempting this exercise, the kind of wood 
and strength of the branches must be considered. Summer is 
the best time for practicing it, as withered branches are then 
most easily discerned ; and even then it is best to climb low trees, 
until some experience is acquired. As the surface of branches is 
smooth, or moist and slippery, the hands must never for a moment 
be relaxed. 



PHYSIOLOGY AND LAWS OF LIFE. 705 



CHAPTER XII. 

^ PHYSIOLOGY AND LAWS OF LIFE. 

On Life. 

Life is a vortex, more or less rapid, more or less complicated, 
tlie direction of which is invariable, and which always carries along 
atoms or molecules of similar kinds, but into which individual mole- 
cules are continually entering, and from which they are continually 
departing ; so that the form of a living body is more essential to 
it than its matter. 

As long as this motion subsists — the body in which it takes place 
is living — it lives ; when it finally ceases, it dies. After death, the 
elements which compose it, abandoned to the ordinary chemical 
affinities, soon separate, from which, more or less quickly, results 
the dissolution of the once living body. It was, then, by the vital 
motion that its dissolution was arrested, and its elements were held 
in a temporary union. 

All living bodies die after a certain period, whose extreme hmit 
is fixed for each species, and death appears to be a necessary con- 
sequence of life, which, by its own action, insensibly alters the 
structure of the body, so as to render its continuance impossible. 

In fact, the living body undergoes gradual but continual changes 
during the whole term of its existence. At first it increases in 
dimensions, according to proportions, and within limits, fixed for 
each species and for each one of its parts ; it then augments in 
density in the most of its parts. It is this second kind of change 
that appears to be the cause of natural death. 

If we examine the various living bodies more closely, we find they 
possess a common structure, which a little reflection soon causes 
us to perceive is essential to a vortex such as the vital motion. 

Solids, it is plain, are necessary to these bodies for the mainten- 
ance of their forms, and fluids for the conservation of motion in 
45 



706 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

them. Their tissue, accordingly, is composed of network and 
plates, or of fibers and solid lamina, within whose interstices are 
contained the fluids ; it is in these fluids that the motion is most 
continued and extended. Foreign substances penetrate the body 
and unite with them ; they nourish the solids by the interposition 
of their molecules, and also detach from them those that are super- 
fluous. It is in a liquid or gaseous form that the matters to be 
exhaled traverse the pores of the living body, but, in return, it is 
the solids which contain the fluids, and by their contraction com- 
municate to them part of their motion. 

This mutual action of the fluids and solids, this transition of 
molecules, required considerable affinity in their chemical compo- 
sition ; and such is the fact — the solids of organized bodies being 
mostly composed of elements easily convertible into fluids or gases. 

The motion of the fluids needing also a constantly-repeated 
action on the part of the solids, and communicating one to them, 
required in the latter both flexibility and dilatability, and, accord- 
ingly, we find this character nearly general in all organized solids. 

This structure, common to all living bodies, this areolar tissue, 
whose more or less flexible fibers or laminae intercept fluids more 
or less abundant, constitutes what is called the 07\ganization. As 
a consequence of what we have said, it follows that life can be en- 
joyed by organized bodies only. 

Organization, then, results from a great variety of arrangements, 
which are all conditions of life ; and it is easy to conceive that if 
its efi'ects be to alter either of these conditions, so as to arrest 
even one of the partial motions of which it is composed, the gen- 
eral movement of life must cease. 

Every organized body, independently of the qualities common to 
its tissue, has a form peculiar to itself, not merely general and ex- 
ternal, but extending to the detail of the structure of each of its 
parts ; and it is upon this form, which determines the particular 
direction of each of the partial movements that take place in it, 
that depends the complication of the general movement of its life ; 
it constitutes its species and renders it what it is. Each part 
cooperates in this general movement by a peculiar action, and ex- 
periences from it particular efi'ects, so that in every being life is 
a whole, resulting from the mutual action and reaction of all its 
parts. 

Life, then, in general, presupposes organization in general, and 



PHYSIOLOGY AND LAWS OF LIFE. 707 

the life proper to each individual being presupposes an organiza- 
tion peculiar to that being, just as the movement of a clock pre- 
supposes the clock ; and, accordingly, we behold life only in beino-g 
that are organized and formed to enjoy it, and all the efforts of 
philosophy have never been able to discover matter in the act of, 
organization, neither per se nor by any external cause. In fact, 
life exercising upon the elements which at every moment form part 
of the living body, and upon those which it attracts to it, an action 
contrary to that which, without it, would be produced by the usual 
chemical affinities, it seems impossible that it can be produced by 
these affinities, and yet we know of no other power in nature capa- 
ble of reuniting previously separated molecules. 

The birth of organized beings is, therefore, the greatest mystery 
of the organic economy and of all nature ; we see them developed, 
but never being formed. Nay, more : all those whose origin we can 
trace have at first been attached to a body similar in form to their 
own, but which was developed before them — in a word, to a parent. 
So long as the offspring has no independent existence, but partici- 
pates in that of its parent, it is called a germ. 

The place to which the germ is attached, and the cause which 
detaches it and gives it an independent life, vary ; but this primi- 
tive adhesion to a similar being is a rule without exception. The 
separation of the germ is called generation. 

Every organized being reproduces others that are similar to it- 
self; otherwise, death being a necessary consequence of life, the 
species would become extinct. 

Organized beings have even the faculty of reproducing, in de- 
'grees varying with the species, particular parts of which they may 
have been deprived ; this is called the power of reproduction. 

The development of organized beings is more or less rapid, and 
more or less extended, as circumstances are more or less favora- 
ble. Heat, the abundance and species of nutriment, with other 
causes, exercise great influence, and this influence may extend to 
the whole body in general, or to certain organs in particular ; 
thence arises the impossibility of a perfect similitude between the 
offspring and parent. 

Differences of this kind, between organized beings, form what 
are termed varieties. 

There is no proof that all the differences which now distinguish 
organized beings are such as may have been produced by circum- 



708 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

stances. All that has been advanced upon this subject is hypothet- 
ical. Experience, on the contrary, appears to prove that, in the 
actual state of the globe, varieties are confined within rather nar- 
row limits ; and, go back as far as we may, we still find those limits 
the same. 

We are thus compelled to admit of certain forms which, from 
the origin of things, have perpetuated themselves without exceed- 
ing these limits, and every being appertaining to one or other of 
these forms constitutes what is termed a species. Varieties are 
accidental subdivisions of species. 

Generation being the only means of ascertaining the limits to 
which varieties may extend, species should be defined, the reunion 
of individuals descended one from the other, or from common par- 
ents, or from such as resemble them, as strongly as they resemble 
each other. But, although this definition is strict, it will be seen 
that its application to particular individuals may be very difficult 
where the necessary experiments have not been made. 

Thus, then, it stands — absorption, assimilation, exhalation, de- 
velopment, and generation are functions common to all living bodies ; 
birth and death the universal limits of their existence ; an areolar, 
contractile tissue, containing within its laminse fluids or gases in 
motion, the general essence of its structure ; substances almost all 
susceptible of conversion into fluids or gases, and combinations 
capable of an easy and mutual transformation, the basis of their 
chemical composition. Fixed forms that are perpetuated by gen- 
eration distinguish their species, determine the complication of the 
secondary functions proper to each of them, and assign to them the 
parts they are to play on the great stage of the universe. These* 
forms are neither produced nor changed by their own agency ; 
life supposes their existence, its flame can only be kindled in an 
organization already prepared, and the most profound meditation 
and lynx-eyed and delicate observation can penetrate no further 
than the mystery of the preexistence of germs. 

Division of Organized Beings into Animals and Vegetables. — 
Living or organized beings have always been subdivided into ani- 
mate beings — that is, such as are possessed of sense and motion — 
and into inanimate beings, which are deprived of both these facul- 
ties, and are reduced to the simple faculty of vegetating. Although 
the leaves of several plants shrink from the touch, and the roots 



PHYSIOLOGY AND LAWS OF LIFE. 709 

are steadily directed toward moisture, the leaves to light and air, 
and though parts of vegetables appear to oscillate without any 
apparent external cause, still these various notions have too little 
similarity to those of animals to enable us to find in them any 
proofs of perception or will. 

The spontaneity in the motions of animals required essential 
modifications even in their purely vegetative organs. Their roots 
not penetrating the earth, it was necessary they should be able to 
place within themselves a supply of aliment, and to carry its reser- 
voir along with them. Hence is derived the first character of ani- 
mals, or their alimentary canal, from which theii' nutritive fluid 
penetrates all other parts through pores or vessels, which are a 
kind of internal roots. 

The organization of this cavity and its appurtenances required 
varying, according to the nature of the aliment and the operation 
it had to undergo, before it could furnish juices fit for absorption, 
while the air and earth present to vegetables naught but elaborated 
juices ready for absorption. 

The animal, whose functions are more numerous and varied than 
those of the plant, consequently necessitated an organization much 
more complete. Besides this, its parts not being capable of pre- 
serving one fixed relative position, there were no means by which 
external causes could produce the motion of their fluids, which re- 
quired an exemption from atmospheric influence. From this origi- 
nates the second character of animals, their circulating system^ one 
less essential than that of digestion, since in the more simple ani- 
mals it is unnecessary. The animal functions required organic 
systems not needed by vegetables — that of the muscles for volun- 
tary motion, and nerves for sensibility ; and these two systems, 
like the rest, acting only through the motions and transformations 
of the fluids, it was necessary that these should be most numerous 
in animals, and that the chemical composition of the animal body 
be more complex than that of the plant ; and so it is, for one sub- 
stance more (azote) enters into it as an essential element, while in 
plants it is a mere accidental junction with the three other general 
elements of organization, oxygen, hydrogen, and carbon. This, 
then, is the third character of animals. . 

From the sun and atmosphere vegetables receive for their nu- 
trition water, which is composed of oxygen and hydrogen; air, 
which contains oxygen and azote; and carbonic acid, which is a 



710 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

combination of oxygen and carbon. To extract their own compo- 
sition from these aliments, it was necessary they should retain the 
hydrogen and carbon, exhale the superfluous oxygen, and absorb 
little or no azote. Such, in fact, is vegetable life, -whose essential 
function is the exhalation of oxygen, which is effected through the 
agency of light. 

Animals also derive nourishment, directly or indirectly, from 
the vegetable itself, in which hydrogen and carbon form the prin- 
cipal parts. To assimilate them to their own composition, they 
must get rid of the superabundant hydrogen and carbon in partic- 
ular, and accumulate more azote, which is performed through the 
medium of respiration, by which the oxygen of the atmosphere 
combines with the hydrogen and carbon of their blood, and is ex- 
haled with them in the form of water and carbonic acid. The 
azote, whatever part of the body it may penetrate, seems always 
to remain there. 

The relations of vegetables and animals to the surrounding at- 
mosphere are, therefore, in an inverse ratio ; the former reject water 
and carbonic acid, while the latter produce them. The essential 
function of the animal body is respiration ; it is that which, in a 
manner, animalizes it; and we shall see that the animal functions 
are the more completely exercised in proportion to the greatness 
of the powers of respiration possessed by the animal. This differ- 
ence of relations constitutes the fourth character of animals. 

Of the forms peculiar to the Organic Elements of the Animal 
Body, and of the principal combinations of its Chemical Elements. — 
An areolar tissue and three chemical elements are essential to 
every living body ; there is a fourth element peculiarly requisite 
to that of an animal ; but this tissue is composed of variously- 
formed meshes, and these elements are variously combined. 

There are three kinds of organic materials or forms of texture — 
the cellular membrane, the muscular fiber, and the medullary mat- 
ter — and to each form belongs a peculiar combination of chemical 
elements, as well as a particular function. 

The cellular substance is composed of an aflinity of small fibers 
and laminae, fortuitously disposed, so as to form little cells that 
communicate with each other. It is a kind of sponge, which has 
the same form as the body, all other parts of which traverse or fill 
it, and contracting indefinitely on the removal of the causes of its 



PHYSIOLOaY AND LAWS OF LIFE. 711 

tension. It is this power that retains the obody in a given form 
and within certain limits. 

When condensed, this substance forms those laminss called raem- 
hranes ; the membranes, rolled into cylinders, form those more or 
less ramified tubes named vessels; the filaments, called fibers, are 
resolved into it, and bones are nothing but the same thing indurated 
by the accumulation of earthy particles. 

The cellular substance consists of a combination well known as 
gelatine, characterized by its solubility in boiling water, and form- 
ing, when cold, a trembling jelly. 

We have not yet been able to reduce the medullary matter to its 
organic molecules ; to the naked eye, it appears like a sort of soft 
bouillie, consisting of excessively small globules ; it is not suscep- 
tible of any apparent motion, but in it resides the admirable power 
of transmitting to the me the impressions of the external senses, 
and conveying to the muscles the orders of the will. It constitutes 
the greater portion of the brain and the spinal marrow, and the 
nerves which are distributed to all the sentient organs are, essen- 
tially, mere fasciculi of its ramifications. 

Thefleshi/ or muscular fiber is a peculiar sort of filament, whose 
distinctive property, during life, is that of contracting when touched 
or struck, or when it experiences the action of the will through 
the medium of the nerve. 

The muscles, direct organs of voluntary motion, are mere bun- 
dles of fleshy fibers. All vessels and membranes which have any 
kind of compression to execute are armed with these fibers. They 
are always intimately connected with nervous threads, but those 
which belong to the purely vegetative functions contract, without 
the knowledge of the me, so that, although the will is truly a means 
of causing the fibers to act, it is neither general nor unique. 

The fleshy fiber has for its base a particular substance called 
fihrine, which is insoluble in boiling water, and which seems natur- 
ally to assume this filamentous disposition. 

The nutritive fluid, or the blood, such as w^e find it in the ves- 
sels of the circulation, is not only mostly resolvable into the gen- 
eral elements of the animal body — carbon, hydrogen, oxygen, and 
azote — but it also contains fibrine and gelatine almost prepared to 
contract and to assume the forms of membranes or filaments pecu- 
liar to them, all that is ever wanted for their manifestation being 
a little repose. The blood also contains another combination, 



712 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

whicli is found in many animal fluids and solids, called albumen^ 
whose characteristic property is that of coagulating in boiling 
water. Besides these, the blood contains almost every element 
which may enter into the composition of the body of each animal, 
such as the lime and phosphorus which harden the bones of verte- 
brated animals, the iron from which it and various other parts re- 
ceive their color, the fat or animal oil which is deposited in the 
cellular substance to supple it, etc. All the fluids and solids of 
the animal body are composed of chemical elements found in the 
blood, and it is only by possessing a few elements, more or less, 
that each of them is distinguished, whence it is plain that their 
formation entirely depends on the subtraction of the whole or part 
of one or more elements of the blood, and, in some few cases, on 
the addition of some element from elsewhere. 

These operations, by which the blood nourishes the fluid or solid 
matter of all parts of the body, may assume the general name of 
secretions. This name, however, is often appropriated exclusively 
to the production of liquids, while that of nutrition is more espe- 
cially appHed to the formation and deposition of the matter neces- 
sary to the growth and conservation of the solids. 

The composition of every solid organ, of every fluid, is precisely 
such as fits it for the part it is to play, and it preserves it as long 
as health remains, because the blood renews it as fast as it becomes 
changed. The blood itself, by this continued contribution, is 
changed every moment, but is restored by digestion, which renews 
its matter by respiration, which delivers it from superfluous carbon 
and hydrogen, by perspiration and various other excretions, that 
relieve it from other superabundant principles. These perpetual 
changes of chemical composition form a part of the vital vortex, 
not less essential than the visible movements and those of transla- 
tion. The object of the latter is, in fact, but to produce the former. 

Of the forces which act in the Animal Body. — The muscular 
fiber is not only the organ of voluntary motion, for we have just 
seen that it is also the most powerful of the agents employed by 
nature to produce those transmutations so necessary to vegetative 
life. Thus the fibers of the intestines produce the peristaltic mo- 
tion, which causes the alimentary matter therein contained to pass 
through them ; the fibers of the heart and arteries are the agents 
of the circulation, and through it of ail the secretions, etc. 



PHYSIOLOGY AND LAWS OF LIFE. 713 

■ Volition contracts the fiber through the medium of the nerve, 
and the involuntary fibers, such as those -^^e have mentioned, being 
also animated by them, it is probable that these nerves are the 
cause of then' contraction. 

All contraction, and, generally speaking, every change of dimen* 
sion in nature, is produced by a change of chemical composition, 
though it consist merely in the flowing or ebbing of an imponder- 
able fluid, such as caloric ; thus also are produced the most violent 
movements known upon earth, explosions, etc. 

There is, consequently, good reason to suppose that the nerve 
acts upon the fiber through the medium of an imponderable fluid, 
and the more so as it is proved that this action is not mechanical. 

The medullary matter of the whole nervous system is homoge- 
neous, and must be able to exercise its peculiar functions wherever 
it is found; all its ramifications are abundantly supplied with 
blood-vessels. 

All the animal fluids being drawn from the blood by secretion, 
we can have no doubt that such is the case with the nervous fluid, 
and that the medullary matter secretes it. 

On the other hand, it is certain that the medullary matter is the 
sole conductor of the nervous fluid ; all the other organic elements 
restrain and arrest it, as glass arrests electricity. 

The external causes which are capable of producing sensations, 
or causing contractions of the fiber, are all chemical agents, capa- 
ble of efi'ecting decompositions, such as light, caloric, the salts, 
odorous vapors, percussion, compression, etc. 

It would appear, then, that these causes act on the nervous fluid 
chemically, and by changing its composition; this appears the more 
likely, as their action becomes weakened by continuance, as if the 
nervous fluid needed the resumption of its primitive composition 
to fit it for a fresh alteration. 

The external organs of the senses may be compared to sieves, 
which allow nothing to pass through to the nerve except that 
species of agent which should affect it in that particular place, 
but which often accumulates it so as to increase its eifect. The 
tongue has its spongy papillae, which imbibe saline solutions ; the 
ear, a gelatinous pulp, which is violently agitated by sonorous vi- 
brations; the eye, transparent lenses, which concentrate the rays 
of light, etc. 

It is probable that what are styled hritants, or the agents which 



714 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

occasion the contractions of the fiber, exert this action by produc- 
ing on the fiber, by the nerve, a similar efi'ect to that produced on 
it by the will; that is, by altering the nervous fluid in the way 
that is requisite to change the dimensions of the fiber which it in- 
fluences; but with this process the will has nothing to do, and very 
often the me is entirely ignorant of it. The muscles, separated 
from the body, preserve their susceptibility of irritation as long as 
the portion of the nerve that remains with them preserves the 
power of acting on them ; with this phenomenon the will has evi- 
dently no connection. 

The nervous fluid is altered by muscular irritation, as well as 
by sensibility and voluntary motion, and the same necessity exists 
for the reestablishment of its primitive composition. 

The transmutations necessary to vegetable life are occasioned 
by irritants ; the aliment irritates the intestine, the blood irritates 
the heart, etc. These movements are all independent of the will, 
and generally (while in health) take place without the knowledge 
of the ME ; in several parts, the nerves that produce them are even 
differently arranged from those that are appropriated to sensation 
or dependent on the will, and the very object of this difi'erence ap- 
pears to be the securing of this independence. 

The nervous functions — that is, sensibility and muscular irrita- 
bility — are so much the stronger at every point, in proportion as 
their exciting cause is abundant; and as this cause, or the nervous 
fluid, is produced by secretion, its abundance must be in proportion 
to the quantity of medullary or secretory matter, and the amount 
of blood received by the latter. 

In animals that have a circulating system, the blood is propelled 
through the arteries which convey it to its destined parts, by means 
of their irritability and that of the' heart. If these arteries be irri- 
tated, they act more strongly, and propel a greater quantity of 
blood ; the nervous fluid becomes more abundant, and augments the 
local sensibility; this, in its turn, augments the irritability of the 
arteries, so that this mutual action may sometimes be carried to 
a great extent. It is called orgasm, and when it becomes painful 
and permanent, inflammation. The irritation may also originate in 
the nerve, when exposed to the influence of acute sensations. 

This mutual influence of the nerves and fibers, either intestinal 
or arterial, is the real spring of vegetative life in animals. 

As each external sense is permeable only by such or such sen- 



PHYSIOLOGY AND LAWS OF LIFE. 715 

sible substances, so each internal organ may be accessible only to 
this or that agent of irritation. Thus, mercury irritates the salivary 
glands, cantharides irritate the bladder, etc. These agents are 
called specifics. 

The nervous system being homogeneous and continuous, local 
sensations and irritation debilitate the whole, and each function, 
by excessive action, may weaken the others. Excess of aliment 
weakens the power of thought, w^hile long-continued meditation 
impairs that of the digestion, etc. 

Excessive local irritation will enfeeble the whole body, as if all 
the powers of life were concentrated in one single point. 

A second irritation produced at another part may diminish or 
divert, as it is termed, the first; such is the effect of blisters, pur- 
gatives, etc. 

Brief as our sketch has been, it is sufficient to establish the pos- 
sibility of accounting for all the phenomena of physical life, from 
the properties it presents, by the simple admission of a fluid such 
as we have defined. 

Summary idea of the Functions and Organs of the Bodies of 
Animals^ and of their various degrees of Complication. — After what 
we have stated respecting the organic elements of the body, its 
chemical principles and acting powers, nothing remains but to give 
a summary idea of the functions of which life is composed, and of 
their appropriate organs. 

The functions of the animal body are divided into two classes : 

The animal functions, or those proper to animals; that is to 
say, sensibility and voluntary motion. 

The vital, vegetative functions, or those common to animals and 
vegetables; that is, nutrition and generation. 

Sensibility resides in the nervous system. 

The most general external sense is that of touch ; it is seated 
in the skin, a membrane that envelopes the whole body, which is 
traversed in every direction by nerves whose extreme filaments 
expand on the surface into papillse, and are protected by the epi- 
dermis and other insensible teguments, such as hairs, scales, etc. 
Taste and smell are merely delicate states of the sense of touch, 
for which the skin of the mouth and nostrils is particularly organ- 
ized — the first by means of papillae more convex and spongy, the 
second by its extreme delicacy and the multiplication of its ever 



716 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

humid surface. We have already spoken of the ear and the eye. 
The organ of generation is endowed with a sixth sense, seated in 
its internal skin ; that of the stomach and intestines declares the 
state of those viscera by peculiar sensations. In fine, sensations 
more or less painful may originate in every part of the body 
through accident or disease. 

Many animals have neither ears nor nostrils, several are without 
eyes, and some are reduced to the single sense of touch, which is 
never absent. 

The action received by the external organs is continued by the 
nerves to the central masses of the nervous system, which, in the 
higher animals, consists of the brain and spinal marrow. The 
more elevated th» nature of the animal, the more voluminous is 
the brain, and the more is the sensitive power concentrated there; 
the lower the animal, the more the medullary masses are dispersed, 
and in the most imperfect genera the entire nervous substance 
seems to melt into the general matter of the body. 

That part of the body which contains the brain and principal 
organs of sense is called the head. 

When the animal has received a sensation, and this has occa- 
sioned volition, it is by the nerves, also, that this volition is trans- 
mitted to the muscles. 

The muscles are bundles of fleshy fibers, whose contractions pro- 
duce all the movements of the animal body. The extension of the 
limbs and every elongation, as well as every flexion and abbrevia- 
tion of parts, are the eff'ects of muscular contraction. The muscles 
of every animal are arranged, both as respects number and direc- 
tion, according to the movements it has to make ; and when these 
motions require force, the muscles are inserted into hard parts, ar- 
ticulated one over another, and may be considered as so many levers. 
These parts are called bones in the vertebrated animals, where 
they are internal, and are formed of a gelatinous mass, penetrated 
by particles of phosphate of lime. In the mollusca, the Crustacea, 
and insects, where they are external, and composed of a calcareous 
or horny substance that exudes between the skin and epidermis, 
they are called shells, crusts, and scales. 

The fleshy fibers are attached to the hard parts by means of 
other fibers of a gelatinous nature, which seem to be a continua- 
tion of the former, constituting what are called tendons. 

The configuration of the articulating surfaces of the hard parts 



PHYSIOLOGY AND LAWS OF LIFE. 717 

limits their motion, which are also restrained by cords or envelopes, 
attached to the sides of the articulations, called ligaments. 

It is from the various arrangements of this bony and muscular 
apparatus, and the form and proportion of the members therefrom 
resulting, that animals are capable of executing the innumerable, 
movements that enter into walking and leaping, flight and natation. 

The muscular fibers, appropriated to digestion and the circula- 
tion, are independent of the will ; they receive nerves, however, 
but the chief of them are subdivided and arranged in a manner 
which seems to have for its object their independence of the me. 

It is only in paroxysms of the passions, and other powerful affec- 
tions of the soul, which break down these barriers, that the empire 
of the ME is perceptible, and even then it is almost always to dis- 
order these vegetative functions. It is, also, in a state of sickness 
only that these functions are accompanied with sensations ; diges- 
tion is usually performed unconsciously. 

The aliment divided by the jaws and teeth are sucked up when 
liquids constitute the food, is swallowed by the muscular move- 
ments of the hinder parts of the mouth and throat, and deposited 
in the first portions of the alimentary canal that is usually expanded 
into one or more stomachs ; there it is penetrated with juices fitted 
to dissolve it. Passing thence through the rest of the canal, it 
receives other juices destined to complete its preparation. The 
parietes of the canal are pierced with pores which extract from this 
alimentary mass its nutritious portion ; the useless residuum is re- 
jected as excrement. 

The canal in which this first act of nutrition is performed is a 
continuation of the skin, and is composed of similar layers ; even 
the fibers that encircle it are analogous to those which adhere to 
the internal surface of the skin, called the fleshy pannicle. Through- 
out the whole interior of this canal there is a transudation which 
has some connection with the cutaneous perspiration, and which 
becomes more abundant when the latter is suppressed ; the absorp- 
tion of the skin is even very analogous to that of the intestines. 
It is in the lowest order of animals that the excrements are rejected 
by the mouth, their intestines resembling a sac, with but the one 
opening. 

Even among those where the intestinal canal has two orifices, 
there are many in which the nutritive juices, being absorbed by the 
parietes of the intestine, are immediately diffused throughout the 



718 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

whole spongy substance of the body ; such, it would appear, is the 
case with all insects. But from the arachnoides and worms up- 
ward, the nutritive fluid circulates in a system of closed vessels, 
whose ultimate ramifications alone dispense its molecules to the 
parts that are nourished by it ; the vessels that convey it are called 
arteries ; those that bring it back to the center of the circulation, 
veins. The circulating vortex is here simple, and there double and 
even triple (including that of the vena portse) ; the rapidity of its 
motion is often assisted by the contractions of a certain fleshy ap- 
paratus called a heart, which is placed at one or the other centers 
of circulation, and sometimes at both of them. 

In th,e red-blooded vertebrated animals, the nutritive fluid exudes 
from the intestines, white or transparent, and is then termed chyle ; 
it is poured into the veins, where it mingles with the blood, by two 
peculiar vessels called lacteals. Vessels similar to these lacteals, 
and forming with them an arrangement called the lymphatic sys- 
tem, also convey to the venous blood the residue of the nutrition 
of the parts and the products of cutaneous absorption. 

Before the blood is fit to nourish the parts, it must experience 
from the circumambient element, the modification of which we have 
previously spoken. In animals possessing a circulating system, 
one portion of the vessels is destined to carry the blood into organs 
in which they spread it over a great surface to obtain an increase 
of this elemental influence. When that element is' air, the surface 
is hollow, and is called lungs; when it is water, it is salient, and 
is termed hranchioe. There is always an arrangement of the organs 
of motion for the purpose of propelling the element into, or upon, 
the organ of respiration. 

In animals destitute of a circulating system, air is difi'used 
through every part of the body by elastic vessels called trachece ; 
or water acts upon them, either by penetrating through vessels, 
or by simply bathing the surface of the skin. The respired or 
purified blood is properly qualified for restoring the composition 
of all the parts, and to eff'ect what is properly called nutrition. 
This facility, which the blood possesses, of decomposing itself a.t 
every point, so as to leave there the precise kind of molecule 
necessary, is indeed wonderful ; but it is this wonder which consti- 
tutes the whole vegetative life. For the nourishment of the solids 
we see no other arrangement than a great subdivision of the ex- 
treme arterial ramifications, but for the production of fluids the 



PHYSIOLOGY AND LAWS OF LIFE. 719 

apparatus is more complex and various. Sometimes the extremi- 
ties of the vessels simply spread themselves over large surfaces, 
whence the produced fluid exhales ; at others it oozes from the 
bottom of little cavities. Before these arterial extremities change 
into veins, they most commonly give rise to particular vessels that 
convey this fluid, which appears to proceed from the exact point 
of union between the two kinds of vessels ; in this case the blood- 
vessels and these latter form, by interlacing, particular bodies, 
called conglomerate or secretory glands. 

In animals that have no circulation, in insects particularly, the 
parts are all bathed in the nutritive fluid ; each of these parts 
draws from what it requires, and if the production of a liquid be 
necessary, proper vessels floating in the fluid take up by their pores 
the constituent elements of that liquid. 

It is thus that the blood incessantly supports the composition of 
all the parts, and repairs the injuries arising from those changes 
which are the continual and necessary consequences of their func- 
tions. The general ideas we form with respect to this process are 
tolerably clear, although we have no distinct or detailed notion of 
what passes at each point, and, for want of knowing the chemical 
composition of each part with sufficient precision, we can not ren- 
der an exact account of the transmutations necessary to eff'ect it. 

Besides the glands which separate from the blood those fluids 
that are destined for the internal economy, there are some which 
detach others from it that are to be totally ejected, either as 
superfluous — the urine, for instance, which is produced by the 
kidneys — or for some use to the animal, as the ink of the cuttle- 
fish, and the purple matter of various mollusca, etc. 

With respect to generation, there is a process or phenomenon, 
inflnitely more difficult to comprehend than that of the secretions — 
the production of the germ. We have even seen that it is to be 
considered as almost incomprehensible ; but the existence of the 
germ being admitted, generation presents no particular difficulties. 
As long as it adheres to the parent, it is nourished as if it were 
one of its organs, and when it detaches itself, it possesses its own 
life, which is essentially similar to that of the adult. 

The germ, the embryo, the foetus, and the new-born animal have 
never, however, exactly the same form as the adult, and the difi'er- 
ence is sometimes so great that their assimilation has been termed 
a metamorphosis. Thus, no one not previously aware of the fact 



720 . AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

would suppose for a moment that the caterpillar is to become a 
butterfly. 

Every living being is more or less metamorphosed in the course 
of its growth ; that is, it loses certain parts, and develops others. 
The antennae, wings, and all the parts of the butterfly were in- 
closed beneath the skin of the caterpillar ; this skin vanishes along 
with the jaws, feet, and other organs that do not remain with the 
butterfly. The feet of the frog are inclosed by the skin of the 
tadpole; and the tadpole, to become a frog, parts with its tail, 
mouth, and branchiae. The child, at birth, loses its placenta and 
membranes ; at a certain period its thymus gland nearly disappears, 
and it gradually acquires hair, teeth, and beard ; the relative size 
of its organs is altered, and its body augments in a greater ratio 
than its head, the head more than the internal ear, etc. 

The place where these germs are found, and their germs them- 
selves, are collectively styled the ovary ; the canal through which, 
when detached, they are carried into the uterus, the oviduct; the 
cavity in which, in many species, they are compelled to remain for 
a longer or shorter period previous to birth, the uterus; and the 
external orifice through which they pass into the world, the vulva. 
Where there are sexes, the male impregnates, the germs appearing 
in the female. The fecundating liquor is called semen ; the glands 
that separate it from the blood, testes; and when it is requisite it 
should be carried into the body of the female, the introductory 
organ is named a penis. 

Of the Intellectual Functions of Animals. — The impression of 
external objects upon the me, the production of a sensation or of 
an image, is a mystery into which the human understanding can 
not penetrate ; and materialism a hypothesis, so much the more 
conjectural, as philosophy can furnish no direct proof of the actual 
existence of matter. The naturalist, however, should examine what 
appear to be the material conditions of sensation, trace the ulterior 
operations of the mind, ascertain to what point they reach in each 
being, and assure himself whether they are not subject to condi- 
tions of perfection, dependent on the organization of each species, 
or on the momentary state of each individual body. 

To enable the me to perceive, there must be an uninterrupted 
communication between the external sense and the central masses 
of the medullary system. It is, then, the modification only expe- 



PHYSIOLOGY AND LAWS OF LIFE. 721 

rienced by these masses that the me perceives ; there may also be 
real sensations, without the external organ being eifected, and which 
originate either in the nervous chain of communication, or in the 
central mass itself; such are dreams and visions, or certain acci- 
dental sensations. 

By central masses, we mean a part of the nervous system, that 
is so much the more circumscribed, as the animal is the more per- 
fect. In man it consists exclusively of a limited portion of the 
brain ; but in reptiles it includes the brain and the whole of the 
medulla, and of each of their parts taken separately, so that the 
absence of the entire brain does not prevent sensation. In the 
inferior classes this extension is still greater. 

The perception acquired by the me produces the image of the 
sensation experienced. We trace to without the cause of that sen- 
sation, and thus acquire the idea of the object that has produced 
it. By a necessary law of our intelligence, all ideas of material 
objects are in time and space. 

The modifications experienced by the medullary masses leave 
impressions there which are reproduced, and thus recall to the mind 
images and ideas ; this is memory^ a corporeal faculty that varies 
greatly, according to the age and health of the animal. 

Similar ideas, or such as have been acquired at the same time, 
recall each other ; this is the association of ideas. The order, ex- 
tent, and quickness of this association constitute the perfection of 
memory. 

Evei-y object presents itself to the memory with all its qualities 
or with all its accessory ideas. 

Intelligence has the powder of separating these accessory ideas 
of objects, and of combining those that are alike in several differ- 
ent objects under a general idea, the object of which nowhere 
really exists nor presents itself per se; this is alstraction. 

Every sensation being more or less agreeable or disagreeable, 
experience and repeated essays soon show what movements are 
required to procure the one and avoid the other ; and, with respect 
to this, the intelligence abstracts itself from the general rules to 
direct the will. 

An agreeable sensation being liable to consequences that are not 
so, and vice versa, the subsequent sensations become associated with 
the idea of the primitive one, and modify the general rules framed 
by intelligence ; this is prudence. 
46 



722 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

From the application of these rules to general ideas result cer- 
tain formula, which are afterward easily adapted to particular 
cases ; this is called reasoning. 

A lively remembrance of primitive and associated sensations, 
and of the impressions of pleasure or pain that belong to them, 
constitutes imagination. 

One privileged being, MAN^ has the faculty of associating his 
general ideas with particular images more or less arbitrary, easily 
impressed upon the memory, and which serve to recall the general 
ideas they represent. These associated images are styled signs; 
their assemblage is a language. When the language is composed 
of images that relate to the sense of hearing or of sounds^ it is 
termed speech, and when relative to that of sight, JiyeroglypMcs. 
Writing is a suite of images that relates to the sense of sight, by 
which we represent the elementary sounds, and, by combining 
them, all the images relative to the sense of hearing of which 
speech is composed ; it is, therefore, only a mediate representation 
of ideas. 

This faculty of representing general ideas by particular signs or 
images associated with them, enables us to retain distinctly, and 
to remember without embarrassment, an immense number; and 
furnishes to the reasoning faculty and the imagination innumera- 
ble materials, and to individuals means of communication, which 
cause the whole species to participate in the experience of each 
individual, so that no bounds seem to be placed to the acquisition 
of knowledge ; it is the distinguishing character of human intelli- 
gence. 

Although, with respect to the intellectual faculties, the most 
perfect animals are infinitely beneath man, it is certain that their 
intelligence performs operations of the same kind. They move in 
consequence of sensations received, are susceptible of durable af- 
fections, and acquire, by experience, a certain knowledge of things 
by which they are governed independently of actual pain or pleas- 
ure, and by the simple foresight of consequences. When domes- 
ticated, they feel their subordination, know that the being who 
punishes them may refrain from so doing if he will, and when sen- 
sible of having done wrong, or behold him angry, they assume a 
suppliant and deprecating air. In the society of man they become 
either corrupted or improved, and are susceptible of emulation and 
jealousy ; they have among themselves a natural language, which^ 



PHYSIOLOGY AND LAWS OF LIFE. 723 



it is true, is merely the expression of their momentary sensations, 
but man teaches them to understand another, much more compli- 
cated, by which he makes known to them his will, and causes them 
to execute it. 

To sum up all, we perceive in the higher animals a certain de-, 
gree of reason, with all its consequences, good and bad, and which 
appears to be about the. same as that of children ere they have 
learned to speak. The lower we descend from man, the w^eaker 
these faculties become, and at the bottom of the scale we find them 
reduced to signs (at times equivocal) of sensibility ; that is, to some 
few slight movements to escape from pain. Between these two 
extremes the degrees are infinite. 

In a great number of animals, however, there exists another 
kind of intelligence, called instinct. This induces them to certain 
actions necessary to the preservation of the species, but very often 
altogether foreign to the apparent wants of the individual ; often, 
also, very complicated, and which, if attributed to intelligence, 
would suppose a foresight and knowledge in the species that per- 
form them infinitely superior to what can possibly be granted. 

These actions, the result of instinct, are not the effect of imita- 
tion, for very frequently the individuals who execute them have 
never seen them performed by others ; they are not proportioned 
to ordinary intelligence, but become more singular, more wise, 
more disinterested in proportion as the animals belong to less ele- 
vated classes, and in ail the rest of their actions are more dull and 
stupid. They are so entirely the property of the species, that all 
its individuals perform them in the same way without ever improv- 
ing them a particle. 

The working bees, for instance, have always constructed very 
ingenious edifices, agreeably to the rules of the highest geometry, 
and destined to lodge and nourish a posterity not even their ow^n. 
The solitary bee, and the w^asp, also, form highly complicated nests 
in which to deposit their eggs. From this egg comes a worm 
which has never seen its parent, which is ignorant of the struc- 
ture of the prison in which it is confined, but which, once meta- 
morphosed, constructs another precisely similar. 

The only method of obtaining a clear idea of instinct is by ad- 
mitting the existence of innate and perpetual images or sensations 
in the sensorium, which cause the animal to act in the same w^ay 
as ordinary or accidental sensations usually do. It is a kind of 



724 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

perpetual vision, or dream, that always pursues it, and it may be 
considered, in all that has relation to its instinct, as a kind of som- 
nambulism. 

Instinct has been granted to animals as a supplement to intelli- 
gence, to concur with it, and with strength and fecundity, in the 
preservation, to a proper degree, of each species. 

There is no visible mark of instinct in the conformation of the 
animal; but, as well as it can be ascertained, the intelligence is 
always in proportion to the relative size of the braiuj and partic- 
ularly of its hemispheres. 

Of Food, and the Digestive Process. 

Sources for the Demand of Aliment — Hunger and Thirst. — In 
the first place, a due supply of food is required for the first devel- 
opment of the germ into the adult fabric. In all instances, the 
essential character of the act of reproduction appears to be the 
liberation or setting free of a cell-germ, which, according to the 
character of the being that gave origin to it, may be destined to 
evolve either a simple cell (as in the lowest cryptogamic plants), 
a congeries of cells, having a certain degree of variety of form and 
of difference of function (as in the higher classes of the vegetable 
kingdom), or a complex fabric, composed of an immense variety of 
parts, most of them departing widely, in appearance, at least, from 
the original cellular type, and destined to perform a vast variety of 
actions, as we see in the perfectly developed organism of the higher 
animals. The materials which are subservient to this evolution 
are all derived from the external w^orld, either immediately or 
through the medium of the parent. The germs of the lowly cryp- 
togamia are thrown at once upon the world, so to speak, to obtain 
their own livelihood, as mosses, for instance, and they themselves 
occasion the combination of the inorganic elements, which they 
there meet with, into the organic compounds, which are to be ap- 
phed to the development of their simple organisms. In the flower- 
ing plants, on the other hand, the germ is at first supplied with a 
store of nutriment, which has alread}- undergone this preparation, 
by the agency of the parent, and this store, laid up in the seed, is 
employed in the development of the fabric of the young plant until 
its organs are sufficiently evolved to enable it to perform the same 
processes for itself. The same plan is invariably followed in the 



PHYSIOLOGY AND LAWS OF LIFE. 725 

development of the animal, the nutriment stored up m the ovum, 
or egg, being usually sufBcient for the evolution of the fabric until 
it acquires the power of ingesting food for itself; and where this 
is not the case (as in the mammalia), a further provision being 
adopted by which the supply is continued during a lengthened 
period. Even when thrown upon its own resources, the young ani- 
mal is often far from having attained even the form of its parent, 
much less its size, and in the progress of its evolution, a greater 
or less degree of metamorphosis, or change of form, is observable. 
This is not usually so much the case in the higher animals as in 
the lower, because the supply of nutriment is proportionally greater 
in the former, and serves to carry on the development to a later 
period ; but the changes of condition which their germinal struc- 
ture undergoes within the ovum, are really as remarkable as those 
which are presented in the early embryos of the latter after their 
escape from the egg. 

It is desirable to bear in mind that the function of the germ is 
simply that of occasioning the combination of the materials supplied 
by the external world, and of directing the appropriation of those 
materials. The several parts of the complex fabric of the higher 
animals contain a great variety of materials, and it is, therefore, 
requisite, for its development, that it should be duly supplied with 
all these. The demand set up by the fabric, while in course of 
development or evolution, for the materials of its growth, consti- 
tutes, therefore, the primary source of the requirement of food ; 
and the nature of this must be adapted to the wants of the being. 
Thus, the fabric of plants is essentially composed of cellulose, a 
compound of oxygen, hydrogen, and carbon, and the materials re- 
quired for the production of this are simply carbonic acid and water. 
But nearly all plants form some azotized compound in the interior 
of their cells, for the production of which ammonia also is required. 
And in those species which, like the cerealia, form a large quan- 
tity of azotized compounds, and store them up in their seeds, a 
free supply of ammonia is requisite for the production of the great- 
est proportion which they are capable of generating. In animals, 
again, whose tissue chiefly consists of these very azotized com- 
pounds, or of modifications of them, a constant supply of such is 
required during the whole period of the development of the fabric, 
as well as subsequently ; and if they be not afforded in suflScient 
amount, the evolution of the organism is either retarded or checked 



726 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

altogether. But there is one tissue, namely, fat, the peculiar char- 
acters of which are derived from the presence of a non-azotized 
substance in its cells ; and this can not be developed unless there 
be in the food either oily, saccharine, or amylaceous matters, from 
any of which the fatty compounds may be generated. 

The full development of the animal fabric, however, does not, by 
any means, involve the cessation of the demand for food ; in fact^ 
during the whole period of that development, it may be observed 
that the amount of nutriment ingested is far greater than that 
which is applied to the simple extension of the structure. One 
source of this constant demand is to be found in the continual waste 
or disintegration of the fabric, which goes on to a certain extent 
under all circumstances, but which varies in degree according to 
certain conditions not difficult to be understood. All organized sub- 
stances are liable, from the peculiarity of their chemical composi- 
tion, to decay ; and this operates in the living as much as in the 
dead body. The difference is, that in the living fabric there is a 
provision for at once removing the products of decay, so that they 
may be cast out of the system as soon as possible, while in the 
dead body they remain and act as ferments, hastening the decom- 
position of other parts. Now, the amount of this decay varies 
with the temperature, being increased by warmth and retarded by 
cold. It is consequently greatest in warm-blooded animals, the 
temperature of whose bodies is constantly sustained at a high stand- 
ard ; it is reduced to its minimum in the torpid condition of cold- 
blooded animals, which is brought on by the agency of cold. There 
is another source of waste and decay which is common to animals, 
and all but the simplest plants ; this results from the limited dura- 
tion of life in the individual parts which are most actively con- 
cerned in the vegetative functions. We have seen that the essen- 
tial instruments in the various functions of absorption, assimilation, 
respiration, secretion, and reproduction are cells, each of which 
goes through a certain series of processes, and then dies and decays, 
just as do the isolated cells which compose the entire fabric of the 
simplest plants. This is evidenced to us in the vegetable kingdom 
by the " fall of the leaf," which is nothing else than the result of 
the death and decay of the component cells of that organ, after 
having fulfilled their peculiar functions, these consisting in the 
preparation or elaboration of the nutritious sap, from which the 
various tissues and secretions of the plant are subsequently gener- 



PHYSIOLOGY AND LAWS OF LIFE. 727 

ated. The same process is continually taking place, though in a 
less obvious manner in the animal body, the rate of death and re- 
newal of each group of cells being greater as the functions to 
which it ministers are energetically performed, while the energy 
of these operations is mainly dependent upon the demand set up^ 
by the exercise of the animal functions for the reparation of the 
nervous and muscular tissues. 

The great source of waste and decay in the animal body, and 
consequently the chief source of the demand for food, is the sepa- 
ration of the nervous and muscular tissues, which has been shown 
to be a necessary condition of their functional activity. Every 
manifestation of nervous power, of whatever kind, seems to require 
the combination of oxygen with the elements of nervous matter, 
the normal composition of which is thus destroyed, so that it ceases 
to be fit to form part of the body, and is cast out by the various 
processes of excretion. The same is the case in regard to the 
muscular substance, the waste of which is conformable to the use 
made of it. The demand for the materials of reparation will fol- 
low the same proportion ; and, as the preparation of these mate- 
rials can only be effected by the agency of the vegetative or nu- 
tritive functions, the rate at which these are performed will be 
greatly influenced by the activity of the animal functions. Hence 
we see the necessity of regulating the supply of food in accordance 
with the state of the latter, since a diet which would be superfluous 
and injurious to an individual of inactive habits, is suitable and ben- 
eficial to one w^ho is leading a life of continual exertion. This 
difi"erence manifests itself remarkably in the contrast between ani- 
mals of different tribes, whose natural instincts lead them to dif- 
ferent modes of life. The birds of most active flight, and those 
animals which are required to put forth the greatest efi'orts to ob- 
tain their food, need the largest and most constant supplies of 
food; but even the least active of these classes stand in remark- 
able contrast with reptiles, whose slow and feeble movements are 
attended with so little waste that they can sustain life for weeks, 
and even months, with little or no diminution of their usual ac- 
tivity, without a fresh supply of food. 

Finally, there is a most important cause of demand for food 
among the the higher animals, which does not exist either among 
the lower animals or in the vegetable kingdom, at least to any 
great degree. In the classes of mammals (animals which suckle 



728 AMERICAN HOUSEHOLD BOOK OF MEDICINE. ^ 

their young) and birds, and in that of insects, also, we find a capa- 
bility of sustaining the heat of the body at a fixed standard, which is 
usually far above that of the surrounding medium. This they are 
enabled to do, as will be explained hereafter, by a process similar 
to ordinary combustion, the carbon and hydrogen, which are di- 
rectly supplied by their food, or which have been employed for a 
time in the composition of their living tissues and then set free, 
being made to combine with oxygen introduced by the respiratory 
process, and thus giving out the same heat as if the same mate- 
rials were burned in a furnace. It will be hereafter shown that 
the immediate cause of death in a warm-blooded animal, from 
which the food has been entirely withheld, is the inability any 
longer to sustain the temperature which is requisite for the per- 
formance of its vital operations. Hence we see the necessity for 
a constant supply of food, in the case of warm-blooded animals, for 
this purpose alone, and the demand will be regulated by the ex- 
ternal temperature. When the heat is rapidly carried off from the 
surface by the chilling influence of the surrounding air or water, 
a much greater amount of carbon and hydrogen must be consumed 
within the body, to maintain its proper heat, than when the medium 
is nearly as warm as the body itself; so that a diet Avhich is ap- 
propriate in the former circumstances is superfluous and injurious 
in the latter, and the food which is amply sufficient in a warm 
climate is utterly destitute of power to enable it to resist the in- 
fluence of severe cold. Substances rich in carbon and hydrogen, 
and having little or no oxygen, afford the most efficient heat-sus- 
taining materials ; but it is an essential condition of their due ac- 
tion that they should be of a kind that renders them capable of 
being reduced by the solvent action of the stomach, and of being 
absorbed into the system. 

The demand for food is increased by any cause which creates 
an unusual drain or waste in the system. Thus an extensive sup- 
purating action can be sustained only by a large supply of highly 
nutritious food. The mother who has to furnish the daily supply 
of milk, which constitutes the sole support of her offspring, needs 
an unusual sustenance for this purpose. And there are states of 
the system, in which the solid tissues seem to possess an unusual 
tendency to decomposition, and in which an increased supply of 
food is therefore required. This is the case, for example, in dia- 
ibetes, one of the first symptoms of which disease is the craving 



PHYSIOLOGY AND LAWS OF LIFE. 729 

appetite that seems as if it would be never satisfied. And there 
can be no doubt that, putting aside all the other circumstances 
which have been alluded to, there is much difi'erence among indi- 
viduals in regard to the rapidity of the changes which their or- 
ganism undergoes, and the amount of food consequently required- 
for its maintenance. 

The want of solid food is indicated by the sensation of hunger, 
and that of liquid by thirst. The former of these sensations is re- 
ferred to the stomach, and the latter to the throat; but although 
certain conditions of these parts may be the immediate cause of 
the sensations in question, they are really indicative of the re- 
quirements of the system at large ; for the intensity of the feel- 
ings bears no constant relation to the amount of solid or liquid 
food in the stomach, while, on the other hand, it does correspond 
with the excess of demand in the system over the supply afforded 
by the blood; and it is caused to abate by the introduction of the 
requisite materials into the circulating fluid, even though this be 
not accomplished in the usual manner by the ingestion of food into 
the stomach. 

The sense of hunger, however, seems to be immediately de- 
pendent upon some condition of the stomach, and it may be tem- 
porarily alleviated by introducing into the digestive cavity matter 
which is not alimentary. Of the precise nature of that condition, 
however, we have no certain knowledge. It is easy to prove that 
many of the causes which have been assigned for the sensation are 
but little, if at all, concerned in producing it. Thus, mere empti- 
ness of the stomach can not occasion it, since, if the previous meal 
have been ample, the food passes from its cavity sometime before 
a renewal of the uneasy feeling ; and this emptiness may continue 
(in certain disordered states of the system) for many hours, or 
even days, without a return of desire for food. It can not be due, as 
some have supposed, to the action of the gastric fluid upon the coats 
of the stomach themselves, since this fluid is not poured into the 
stomach except when the production of it is stimulated by the 
irritation of the secreting follicles. By Dr. Beaumont it is thought 
that the distension of these follicles with the secreted fluid is the 
proximate cause of hunger, but there is no more reason to believe 
that the secretion of gastric fluid is accumulating during the inter- 
vals when it is not required, than there is in regard to saliva, the 
lachrymal fluid, or any other secretions, which are occasionally 



730 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

poured out in large quantities under the influence of a particular 
stimulus ; and, moreover, it is difficult to imagine how mental emo- 
tion, or any impression on the nervous system alone (which is able, 
as is well known, to dissipate the keenest appetite in a moment), 
can relieve such distension. It may, perhaps, be a more probable 
supposition that there is a certain condition of the capillary circu- 
lation in the stomach, which is preparatory to the secretion, and 
which is excited by the influence of the sympathetic nerves, that 
communicate, as it w^ere, the wants of the general system. This 
condition may be easily imagined to be the proximate cause of the 
sensation of hunger. When food is introduced into the stomach, 
the act of secretion is directly excited, the capillary vessels are 
gradually unloaded, and the immediate cause of the impression on 
the par vagum is withdrawn. By the conversion of the alimentary 
matter into materials fit for the nutrition of the system, the re- 
mote demand also is satisfied; and thus it is that the condition of 
the stomach, just referred to, is permanently relieved by the in- 
troduction of substances that can serve as food. But if the food 
be not of a kind capable of solution and assimilation, the feeling 
of hunger is only temporarily relieved, and soon returns in greater 
force than before. 

The sense of hunger, like other sensations, may not be taken 
cognizance of by the mind, if its attention be strongly directed to- 
ward other objects ; of this fact almost every one engaged in 
active occupations, whether mental or bodily, is occasionally con- 
scious. The nocturnal student, who takes a light and early even- 
ing meal, and, after devoting himself to his pursuits for several 
hours uninterruptedly, retires to rest with a wearied head and an 
empty stomach, but without the least sensation of hunger, is fre- 
quently prevented from sleeping by an indescribable feeling of 
restlessness and deficiency; and the introduction of a small quan- 
tity of food into the stomach w^ll almost instantaneously allay 
this, and procure comfortable rest. Many persons, again, who 
desire to take active exercise before breakfast, are prevented from 
doing so by the lassitude, and even faintness, w^hich it induces — 
the bodily exercise increasing the demand for food, while it draws 
off" the attention from the sensation of hunger. 

The conditions of the sense of thirst appear to be very similar 
to those of hunger. This sense is not referred, however, to the 
stomach, but to the fauces. It is generally considered that it 



PHYSIOLOGY AND LAWS OF LIFE. 731 

immediately results from an impression on the nerves of the stom- 
ach, since, if liquids are introduced into the stomach through an 
oesophagus-tube, they are just as effectual in allaying thirst as if 
they are swallowed in the ordinary manner. It may, however, be 
doubted whether the sense of thirst is not even more immediately 
connected with the state of the general system, than that of hun- 
ger ; for the immediate relief afforded by the introduction of liquid 
into the stomach is fully accounted for by the instantaneous absorp- 
tion of the fluid into the veins, which is known to take place when 
there is a demand for it, not only from Dr. Beaumont's observa- 
tions, but from many experiments made with reference to this par- 
ticular question. This demand is increased with almost equal 
rapidity, by an excess in the amount of the fluid excretions ; and 
it may be satisfied without the introduction of water into the stom- 
ach. Thirst may also be produced, however, by the impression 
made by peculiar kinds of food or drink upon the walls of the ali- 
mentary canal ; thus, salted or highly-spiced meat, fermented 
liquors, when too little diluted, and other similarly irritating agents, 
excite thirst, the purpose of which is obviously to cause ingestion 
of fluid, by which they may be diluted. 

Nature and Destination of the Food of Animals. — The sub- 
stances which are required by animals for the development and 
maintenance of their fabric are of two kinds, the organic and the 
inorganic. The former alone are commonly reckoned as aliments, 
but the latter are really not less requisite for the sustenance of the 
body, which speedily dies if the attempt be made to support it 
upon any organic compounds in a state of purity. In all ordinary 
articles of diet, however, the inorganic matters are present in the 
requisite proportion, and hence they have very commonly escaped 
notice. The nature of these substances, and the mode in which 
they are introduced into the body, will be considered hereafter. 
The organic matters used as food by animals are partly derived 
from the animal and partly from the vegetable kingdom, and they may 
be conveniently arranged under the four following heads : 1. The 
saccharine group, including all those substances derived from the 
vegetable kingdom which are similar in their composition to sugar, 
consisting of oxygen, hydrogen, and carbon alone, and having the 
two first present in the proportions to form water. To this group 
belong starch, gum, woody fiber, and the various tissues of plants, 



732 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

•which closely resemble each other in the proportion of their ele- 
ments, and which may be converted into sugar by chemical pro- 
cesses of a simple kind! 2. The oleaginous group, including oily 
matters, whether derived from the vegetable kingdom or from the 
fatty portions of animal bodies. The characteristic of this class is 
the great predominance of hydrogen and carbon, the small propor- 
tion of oxygen, and the entire absence of nitrogen. 8. The albu- 
minous group, comprising all those substances, whether derived 
from the animal or vegetable kingdom, which are closely allied to 
albumen, and, therefore, to the majority of the animal tissues in 
their chemical composition. In this group a large proportion of 
azote is united with the oxygen, hydrogen, and carbon of the pre- 
ceding. 4. The gelatinous group, consisting of substances derived 
from animal bodies only, which are closely allied to gelatine in 
their composition. These also contain azote, but the proportion of 
their components differs from that of the preceding. 

The compounds of the saccharine group can not, without under- 
going a change, form part of any animal tissue, as there is none 
which they resemble in composition. It will be shown, however, 
that they are convertible, within the animal body, into those of the 
oleaginous group, and, like them, may be deposited in the form of 
adipose or fatty matter. There is no other tissue in the body into 
which they can enter without considerable change, for all others 
are azotized, and it seems extremely improbable that non-azotized 
compounds can, under any circumstances, be converted within the 
body into compounds of the albuminous or gelatinous groups. 

The application of the substances forming the albuminous group, 
to the support of the animal body, by affording the materials for 
the nutrition and reformation of its tissues, needs little explanation. 
The proportions of the four ingredients of which they are all com- 
posed are so nearly the same, that no essential difference appears 
to exist among them, and it is a matter of httle consequence, ex- 
cept as far as the gratification of the palate is concerned, whether 
we feed upon the flesh of animals (fibrine), upon the white of egg 
(albumen), the curd of milk (caseine), the grain of wheat (gluten), 
or the seed of the pea (legumen). All these substances are reduced 
in the stomach to the form of albumen, which resembles the gum 
of plants, in being the raw material, as it were, out of which the 
various fabrics of the body are constructed. But the rule holds 
good with regard to these also, that by being made to feed con- 



PHYSIOLOGY AND LAWS OF LIFE. 733 

stantly on the same substance — boiled white of egg, for instance, or 
meat deprived of the principle (osmazome) that gives it flavor — 
an animal may be effectually starved, its disgust of the food being 
such that, even if it be swallowed, it is not digested. It is very 
interesting to remark that, in the only instance in which nature 
has provided a single article of food for the support of the animal 
body, she has mingled articles from the three first of the preceding 
groups. This is the case in milh, which contains a considerable 
quantity of an albuminous substance, caseine, which forms its curd, 
a good deal of oil]/ matter, the butter, and no inconsiderable amount 
of sugm% which is dissolved in the whey. The proportions of these 
vary in different mammalia, and they depend in part upon the na- 
ture of the food supplied to the animal that forms the milk, but the 
substances are thus combined in every instance. Although the 
greater part of the organized tissue of animals is formed at the 
expense of the albumen and fibrine of their blood, yet many of 
them also contain a large quantity of gelatine. It seems certain 
that this gelatine may be produced out of fibrine and albumen, 
since in animals that are supported on these alone, the nutrition 
of the gelatinous tissues does not seem to be impaired. But it also 
appears that gelatine taken in as food may be applied to this pur- 
pose, for ordinary experience shows that benefit is derived from 
jelly, soup, broth, etc., peculiarly by persons who have been suf- 
fering under exhausting diseases, such as fevers. But it also ap- 
pears certain that it can not be applied to the nutrition of the 
albuminous tissues. Some important experiments have been re- 
cently made in Paris on this subject, with a view of determining 
how far the soup made from crushed bones — which constituted a 
principal article of diet in the hospitals of Paris — was adequate for 
the support of the patients. The result of these has been quite 
confirmatory of previous conclusions ; namely, that gelatine may 
be advantageously mixed with albumen, fibrine, gluten, etc., and 
those other ingredients which exist in meat-soup and bread ; but 
that, when taken alone, it has little more power of sustaining life 
than sugar or starch possesses, and that, even when bread is 
united with gelatine soup, it does not give it the requisite power 
of nutrition. 

If the non-azotized compounds which exist so largely in the food 
of herbivorous animals be not destined to form part (in any con- 
siderable degree at least) of their tissues, the question arises, What 



Y34 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

becomes of them? It is not enough to say that they are deposited 
as fat, since it is only when a large quantity of them is taken in 
that there is any increase in the quantity of fat already in the 
body. We shall hereafter see that they are used up in the pro- 
cess of respiration, being burned off Avithin the body for the pur- 
pose of keeping up its temperature. The process will be hereafter 
considered more in detail, and at present we need only stop to re- 
mark upon the adaptation between the food provided for animals 
in different climates, and the amount of heat which it is necessary for 
then* to produce. Thus the bears, and seals, and whales, from 
which the Esquimaux and the Greenlander derive their support, 
have an enormous quantity of fat in their massive bodies. This fat 
is as much esteemed as an article of food among these people as 
it would be thought repulsive by the inhabitants of southern cli- 
mates ; and by the large quantity of it they consume, they are able 
to support the bitterness of an Arctic winter without appearing to 
suffer more from the extreme cold than do the residents in more 
temperate climates during their winter. On the other hand, the 
antelopes, deer, and wild cattle, which form a large proportion of 
the animal food of savage or half-cultivated nations inhabiting tem- 
perate or tropical regions, possess very little fat ; and the compar- 
atively small supply of carbon and hydrogen, whose combustion is 
required to keep up the bodily temperature of the inhabitants of 
those regions, is derived from the JlesJi of those animals in the man- 
ner that will be presently explained. Every one knows how much 
less vigorous the appetite becomes during the heat of summer than 
it is during the colder portion of the year ; and this is a natural 
result of the diminished demand for the fuel required to maintain 
the temperature. And one great means of preserving the health, 
during a prolonged residence in a hot climate, is to attend to the 
dictates of nature in regard to the quantity of food taken, instead 
of endeavoring (as is the prevalent practice) to stimulate the ap- 
petite by artificial provocatives, stomach bitters, and the like. 

The maintenance of the bodily temperature in carnivorous or 
flesh-eating animals appears to depend upon the combustion of the 
carbon and hydrogen set free by the disintegration of their nervous 
and muscular tissues, this disintegration taking place with much 
more rapidity, in consequence of their almost unceasing activity, 
than it does in the herbivorous animals, which lead comparatively 
inactive lives. Every one who has visited a menagerie must have 



PHYSIOLOGY AND LAWS OF LIFE. 735 

noticed the continual restlessness of the tigers, leopards, hyenas, 
etc., which keep pacing from one end of their narrow cages to the 
other ; and it would seem as if this restlessness were a natural in- 
stinct, impelling them to use muscular exertion sufficient for the 
metamorphosis of an adequate amount of tissue, that enough car- 
bon and hydrogen may be set free for the support of the respira- 
tory process. And we see a corresponding activity in the human 
hunters of the swift-footed antelope and agile deer, which answers 
a similar purpose, and which is remarkably contrasted with the 
stupid inertness of the inhabitants of the frigid zone, which is only 
occasionally interrupted by the necessity of securing the supplies 
of food afforded by the massive tenants of their seas. The nutri- 
tion of the carnivorous races may, then, be thus described : the 
bodies of the animals upon which they feed contain flesh, fat, etc., 
in nearly the same proportion as their own, and all, or nearly all, 
the aliment they consume goes to supply the waste in the fabric 
of their own bodies, being converted into its various forms of tis- 
sue. After having remained in this condition for a certain time, 
varying according to the use that is made of them, these tissues 
undergo another change, which ends in restoring them to inorganic 
•matter, and thus give back to the mineral world the materials 
which were drawn off from it by plants. Of these materials, part 
are burned off, as it were, within the body, by union with the oxy- 
gen of the air taken in through the lungs, and are discharged from 
these organs in the form of carbonic acid and water ; the remain- 
.der are carried off in the liquid form by other channels. Hence, 
we may briefly express the destination of their food in the follow- 
ing manner : 



Food consisting of] ^ };•„;„„ •\ or,^ fv,;c f carbonic acid and water 

?, I convert- J^,„J,l"£^ I i^",,!,,'^. ] thrown off by resniration. 

and other azot.zed ed into j^'^^Ji^e J phoseS mto 1 ^^'^^ and biliary matter, etc. 

J V. "i^^uc. _; jji u C.J. ^" (_ thrown off by other excretior 



albttmen,' fibrine, 
and other a 
compounds 



But in regard to the herbivorous or herb-eating animals the case 
is different. They perspire much more abundantly, and their tem- 
perature is thus continually kept down. They consequently re- 
quire a? more active combustion to develop sufficient bodily heat ; 
and the materials for this are supplied, as we have seen, by the 
non-azotized portions of their food, rather than by the metamor- 
phosis of their own tissues, which takes place with much less ra- 
pidity than in the canivorous tribes. Hence we may thus express 
the destination of this part of their food ; that of the azotized mat- 



736 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

ter, here much smaller in amount, will be the same as in the pre- 
ceding case : 

starch, oil, and") partly foriinosp") ^"* chiefly Tcarbonic acid and water, dis- 
other non-azotized [-converted-^ P'^i'' Vthrown off -^ engaged by the respiratory 
compounds J into (^ j directly as (process. 

The proportion of the food deposited as fat will depend, in part, 
upon the surplus which remains after the necessary supply of 
materials has been afforded to the respiratory process. Hence, 
the same quantity of food being taken, the quantity of fat will be 
increased by causes that check the perspiration, and otherwise 
prevent the temperature of the body from being lowered, so that 
there is need of less combustion within the body to keep up its 
heat. This is consistent with the teachings of experience respect- 
ing the fattening of cattle ; for it is well known that this may be 
accomplished much sooner if the animals are shut up in a warm 
dwelling and covered with cloths than if they are freely exposed 
in the open air. 

Now, the condition of man may be regarded as intermediate be- 
tween these two extremes. The construction of his digestive ap- 
paratus, as well as his own instinctive propensities, point to a 
mixed diet as that which is best suited to his wants. It does not 
appear that a diet composed of ordinary vegetables only is favor- 
able to the full development of either his bodily or mental powers ; 
but this can not be said in regard to a diet of which hread is the 
chief ingredient, since the gluten it contains appears to be as well 
adapted for the nutrition of the animal tissues, as does the flesh of 
animals. On the other hand, a diet composed of animal flesh alone 
is the least economical that can be conceived ; for, since the great- 
est demand for food is created in him (taking a man of average 
habits, in regard to activity and the climate he inhabits), by the 
necessity for a supply of carbon and hydrogen to support his respi- 
ration, this want may be most advantageously fulfilled by the em- 
ployment of a certain quantity of non-azotized food in Avhich these 
ingredients predominate. Thus, it has been calculated that, since 
fifteen pounds of flesh contain no more carbon than four pounds 
of starch, a savage with one carcass, and an equal weight of starch, 
could support life for the same length of time, during which another 
restricted to animal food would require five such carcasses in order 
to procure the carbon necessary for respiration. Hence, we see 
the immense advantage as to economy of food which a fixed agri- 
cultural population possesses over those wandering tribes of hunters 



PHYSIOLOGY AND LAWS OF LIFE. 737 

wliicli still people a large part both of the old and new continents. 
The mixture of the azotized and non-azotized compounds (gluten 
and starch) that exists in wheat flour, seems to be just that which 
is most useful to man ; and hence we see the explanation of the 
fact that, from very early ages, bread has been regarded as the 
" staff of life." In regard to the nutritious properties of different" 
articles of vegetable food, these may be generally estimated by 
the proportion of azote they contain, which is, in almost every in- 
stance, less than that existing in good wheat flour. 

There are certain mineral ingredients which may be said to con- 
stitute part of the food of animals, being necessary to their sup- 
port in the same manner as other mineral substances are necessary 
to the support of plants. Of this kind are common salt, and also 
phosphorus, sulphur, and lime, either in combination or separate. 
The uses of salt are very numerous and important. It consists of 
two substances of opposite qualities, muriatic acid and soda ; and 
the former is the essential ingredient in the gastric juice, while 
the latter performs a very important part in the production of bile. 
Phosphorus is chiefly required to be united with fatty matter, to 
serve as the material of the nervous tissue, and to be combined 
with oxygen and lime, to form the bone-earth, by which the bone 
is consolidated. Sulphur exists in small quantities in several ani- 
mal tissues ; but its part is by no means so important as that per- 
formed by phosphorus. Lime is required for the consolidation 
of the bones. To these ingredients we may also add iron, which 
is a very important element in the red blood of animals. These 
substances are contained more or less abundantly in most articles 
generally used as food ; and where they are deficient the animal 
suffers in consequence, if they are not supplied in any other way. 
Thus, common salt exists in no inconsiderable quantity in the flesh 
and fluids of animals, in milk, and in the egg ; it is not so abun- 
dant, however, in plants, and the deficiency is usually supplied to 
herbivorous animals by some other means. Thus salt is purposely 
mingled with the food of domesticated animals ; and in most parts 
of the world inhabited by wild cattle, there are spots where it ex- 
ists in the soil, and to which they resort to obtain it. Such are 
the "buffalo licks" of this country. Phosphorus exists also in 
the yolk and white of the egg, and in milk, the substances on which 
the young animal subsists during the period of its most rapid 
growth ; and it abounds not only in many animal substances used 
47 



738 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

as food, but also (in the state of phosphate of lime or bone-earth) 
in the seeds of many plants, especially the grasses. In smaller 
quantities it is found in the ashes of almost every plant. Wheii 
flesh, bread, fruit, and husks of grain are used as the chief articles 
of food, more phosphorus is taken into the body than it requires, 
and the excess has to be carried out in the excretions. Sulphur 
is derived alike from vegetable and animal substances. It exists 
in flesh, eggs, and milk ; also in the azotized compounds of plants, 
and (in the form of sulphate of lime) in most of the river and 
spring-water that we drink. Iron is found in the yolk of egg, and 
in milk, as well as in animal flesh ; it also exists, in small quanti- 
ties, in most vegetable substances used as food by man, such as 
potatoes, cabbage, peas, cucumbers, mustard, etc., and probably in 
most articles from which other animals derive their support. Lime 
is one of the most universally diffused of all mineral bodies ; for 
there are very few animal or vegetable substances in which it does 
not exist. It is most commonly taken in among the higher ani- 
mals combined with phosphoric acid, and in this state it exists 
largely in the seeds of most grasses, especially in wheat flour. If 
it were not for their deficiency in phosphate of lime, some of the 
leguminous seeds would be more nutritious than wheaten flour, the 
proportion of azotized matter they contain being greater. A con- 
siderable quantity of lime exists, in the state of carbonate and sul- 
phate, in all hard water. 

The absolute quantity of food required for the maintenance of 
the human body in health varies so much with the' age, sex, and 
constitution of the individual, and with the circumstances in which 
he may be placed, that it would be absurd to attempt to fix any 
standard which should apply to every particular case. The appe- 
tite is the only sure guide for the supply of the wants of each, but 
its indications must not be misinterpreted. To eat when we are 
hungry is an evidently natiiral disposition ; but to eat as long as 
we are hungry may not always be prudent. Since the feeling of 
hunger does not depend so much upon the state of fullness or em- 
tiness of the stomach, as upon the condition of the general system, 
it appears evident that the eating of food can not at once produce 
the efi*ect of dissipating it, though it will do so after a short time ; 
so that, if we eat with undue rapidity, we may continue swallowing 
food long after we have taken as much as will really be required 
for the wants of the system ; and every superfluous particle is not 



PHYSIOLOGY AND LAWS OF LIFE. 739 

merely useless, but injurious. Hence, besides its other important 
ends, the process of thorough mastication is important, as prolono-- 
ing the meal, and giving time to the system to become acquainted, 
as it were, that the supply of its wants is in progress, so that its 
demand may be abated in due time to prevent the ingestion of more , 
than is required. It is very justly remarked, by Dr. Beaumont, 
that the cessation of this demand, rather than the positive sense 
of satiety, is the proper guide. ^' There appears to be a sense of 
perfect intelligence conveyed to the encephahc (pertaining to the 
head) center which, in health, invariably dictates what quantity of 
aliment (responding to the sense of hunger and its due satisfaction) 
is naturally required for the purposes of life, and which, if noticed 
and properly attended to, would prove the most salutary monitor 
of health and effectual preventive of disease. It is not the sense 
of satiety, for this is beyond the point of healthful indulgence, and 
is nature's earliest indication of an abuse and overburden of her 
powers to replenish the system. It occurs immediately previous 
to this, and may be known by the pleasurable sensations of per- 
fect satisfaction, ease, and quiescence of body and mind. It is 
when the stomach says enough; and it is distinguished from sa- 
tiety by the difference of sensations, the latter saying too much.^- 
Every medical man is well aware how generally this rule is trans- 
gressed, some persons making a regular practice of eating to re- 
pletion, and others paying far too httle attention to the preliminary 
operations, and thus ingesting more than is good for them, even 
though they may actually leave off with an appetite. 

Although no universal law can be laid down for individuals, how- 
ever, it is a matter of much practical importance to be able to form 
a correct average estimate. It is from the experience afforded by 
the usual consumption of food by large bodies of men that our 
data are obtained; and these data are sufficient to enable us to 
predict, with tolerable accuracy, what will be required by similar 
aggregations, though they can afford no guide to the consumption 
of individuals. We shall first consider the quantity sufl&cient for 
men in regular active exercise, and then inquire how far that may 
be safely reduced for those who lead a more sedentary life. The 
diet-scale of the British navy may be advantageously taken as a 
specimen of what is required for the first class. It is well known 
that an extraordinary improvement has taken place in the health 
of seamen during the last eighty years, so that three ships can now 



740 AMERICAN HOUSEHOLD BOOK OF MEPTCINE. 

be kept afloat with only the same number of men which were for- 
merly required for two. This is due to the improvement in the 
quality of the food in combination with other prophylactic means. 
At present it may safely be aflirmed that it would not be easy to 
conceive of any diet-scale more adapted to answer the required 
purpose. The health of crews that have been long afloat, and have 
been exposed to every variety of external conditions, appears to 
be preserved (at least when they are under the direction of judi- 
cious officers) to the full, as well as that of persons subject to sim- 
ilar vicissitudes on shore ; and there can be no complaint of insuf- 
ficiency of food, although the allowance can not be regarded as 
superfluous. It consists of from 31 to 35J oz. of dry nutritious 
matter daily ; of this 26 oz. are vegetable, and the rest animal ; 
9 oz. of salt meat, or 4f oz. fresh, being the allowance of the latter. 
This is found to be amply sufficient for the support of strength ; 
and considerable variety is produced by exchanging various parts 
of the diet for other articles. This, however, is sometimes done 
erroneously ; thus, 8 oz. of fresh vegetables, which contain only 
IJ oz. of solid nutriment, are exchanged for 12 oz. of flour, which 
is almost all nutritious. Sugar and cocoa are also allowed, partly 
in exchange for a portion of the spirits formerly served out, the 
diminution of which, especially in the case of boys, has been at- 
tended with great benefit. 

A considerable reduction in this amount is, of course, admissible 
where little bodily exertion is required, and where there is less ex- 
posure to low temperatures. 

It is a curious effect of insufficient nutriment, as shown by the 
recent inquiries of Chossat, that it produces an incapability of di- 
gesting even the limited amount supplied. He found that when 
turtle-doves were supplied with limited quantities of corn, but with 
water at discretion, the whole amount of food taken was scarcely 
ever actually digested, a part of it being rejected by vomiting, or 
passing off' by diarrhea, or accumulating in the crops. It seems 
as if the vital powers were not sufficient to furnish the requisite 
supply of gastric fluid, when the body began to be enfeebled by 
insufficient nutrition, or perhaps, we might well say, the materials 
of the gastric fluid were wanting. Hence, the loathing of food, 
which is often manifested by those who have been subjected to the 
influence of an insufficient diet-scale in our prisons and poor-houses, 
and which has been set down to caprice or obstinacy, and punished 



PHYSIOLOGY AND LAWS OF LIFE. 741 

accordingly, may be actually a proof of the deficiency of the sup- 
ply which we might expect to have been voraciously devoured, if 
really less than the wants of the system require. 

The smallest quantity of food upon which life is known to have 
been supported with vigor, during a prolonged period, is that on 
which Cornaro states himself to have subsisted. This was no more 
than 12 oz. a day, chiefly of vegetable matter, for a period of fifty- 
eight years. There is only one instance on record in which his 
plan was followed ; and there are probably few who could long per- 
severe in it, at least among those whose avocations require much 
mental or bodily exertion. It is certain, however, that life with a 
moderate amount of vigor may be preserved for some time with a 
very limited amount of food; this appears from the records of 
shipwreck and similar disasters. In regard, however, to those who 
have been stated to fast for a period of months or even years, tak- 
ing no nutriment, but maintaining an active condition, it may be 
safely asserted that they were impostors, probably possessing un- 
usual powers of abstinence, which they took care to magnify. The 
instances in which the life of man, or of other mammalia, has been 
prolonged to the greatest extent without water, are those in which, 
from the peculiarity of the circumstances, the cutaneous exhala- 
tion must have been reduced to a very small amount, or in which 
there may have been an actual absorption of water by the skin and 
lungs. Thus, Fodere mentions that some workmen were extricated 
alive, after fourteen days' confinement in a cold damp cavern, in 
which they had been buried under a ruin. And there is a well- 
known case of a hog, which was buried in its sty for 160 days, 
under thirty feet of chalk of dover clifi*, and was dug out alive at 
the end of that time, reduced in weight from 160 lbs. to 40 lbs. ; 
here the temperature would be kept up by the non-conducting 
power of the chalk around, and the air surrounding the animal 
would soon become sufficiently charged with fluid to resist further 
evaporation. The time during which life can be supported under 
total abstinence is usually stated to vary from eight to ten days ; 
the period may be greatly prolonged, however, by the occasional 
use of water, and still more by a very small supply of food. In a 
case recorded by Dr. Willan of a young gentleman who starved 
himself under the influence of a religious delusion, life was pro- 
longed for sixty days, during the whole of which time nothing else 
was taken than a little orange-juice. In a somewhat similar case. 



742 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

which occurred under the author's notice, in the person of a young 
French lady, more than fifteen days elapsed between the time 
that she ceased to eat regularly and the time of her being com- 
pelled to take nourishment; during this period she took a great 
deal of exercise, and her strength seemed to sufi"er but little, al- 
though she swallowed solid food only once, and then in small quan- 
tity. If the cessation of muscular exertion be complete, it seems 
that life is usually more prolonged than where exercise of any kind 
is performed ; and this is what might naturally be expected. In 
certain states of the system commonly known as hysterical^ there 
is frequently a very remarkable disposition for abstinence, and 
power of sustaining it. In a case of this kind, which occurred under 
the author's own notice, a young lady, who had suifered severely 
from the tetanic form of hysteria, was unable to take food for three 
weeks. The slightest attempt to introduce a morsel of solid mat- 
ter into the stomach occasioned very severe vomiting and retching ; 
and the only nourishment taken during the period mentioned was 
a cup of tea once or twice a day, on many days not even this being 
swallowed. Yet the strength of the patient rather increased than 
diminished during this period ; her muscles became firmer, and her 
voice more powerful. It may be well to remark that, under such 
circumstances, the continual persuasions of anxious friends are 
very injurious to the patient, whose return to her usual state will 
probably take place the earlier the more completely she is left to 
herself. 

Of the quantity which can be devoured at a time, it is scarcely 
the place to speak, since such feats of gluttony only demonstrate 
the extraordinary capacity which the stomach may be made to at- 
tain by continual practice. Many amusing instances are related 
by Captain Parry, in his Arctic Voyages ; in one case, a young 
Esquimaux, to whom he had given (for the sake of curiosity) his 
full tether, devoured in four and twenty hours no less than 35 lbs. 
of various kinds of aliment, including tallow candies. A case has 
recently been published of a Hindoo who can eat a whole sheep at 
a time ; this probably surpasses any other instance on record. 
The half-breed voyageurs of Canada, according to Captain Frank- 
lin, and the wandering Cossacs of Siberia, as testified by Captain 
Cochrane, habitually devour a quantity of animal food which would 
be soon fatal to any one unused to it. The former are spoken of 
as very discontented when put on a short allowance of 8 lbs. of 



PHYSIOLOGY AND LAWS OF LIFE. 743 

meat a day, their usual consumption being from 12 to 20 lbs. That 
a much larger quantity of food than that formerly specified may 
be taken with perfect freedom from injurious consequences, under 
a particular system of exercise, etc., appears from the experience 
of those who are tramed for feats of strength, pugilistic encounters,, 
etc. The ordinary belief that the athletic constitution can not be 
long maintained appears to have no real foundation, nor does it 
appear that any ultimate injury results from the system being per- 
severed in for some time. That trained men often fall into bad 
health, on the cessation of the plan, is probably owing in part to 
the intemperance and other bad habits of persons of the class 
usually subjected to this discipline. The effects of trainers' regi- 
men are hardness and firmness of the muscles, clearness of the 
skin, capability of bearing continued severe exercise, and a feeling 
of freedom and lightness (or " corkiness ") in the limbs. During 
the continuance of the system it is found that the body recovers 
with wonderful facility from the effects of injuries ; wounds heal 
very rapidly ; cutaneous eruptions usually disappear. Clearness 
and vigor of mind, also, are stated to be the results of this plan ; 
and it is probable that, where persevering attention and intense 
application are necessary, a modification of this system, in which 
due allowance should be made for the diminished quantity of ex- 
ercise, would be found advantageous. 

Of the Passage of Food along the Alimentary Canal. — The intro- 
duction of alimentary matter into the system is accomplished in 
animals by the reception of the food into an internal cavity where 
it is subjected to a preparatory process to which nothing analogous 
exists in plants, and which is termed digestion. This process may 
be said to have three different purposes in view : the reduction of 
the alimentary matter to a fluid form, so that it may become capa- 
ble of absorption ; the separation of that portion of it which is fit 
to be assimilated or converted into organized texture from that 
which can not serve this purpose, and which is at once rejected; 
and the alteration (when required) of the chemical constitution of 
the former, which prepares it for the important changes it is sub- 
sequently to undergo. The simplest conditions requisite for the 
accomplishment of these purposes are .the following : A fluid capa- 
ble of performing the solution and of effecting the required chemi- 
cal changes ; a fluid capable of separating the unorganizable mat- 



744 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

ter by a process analogous to chemical precipitation ; and a cavity 
or sac in which these operations may be performed. 

Mastication and JDeglutition. — The first step in the process of 
reduction is the mastication of the food, and the impregnation of 
its pulverized particles with the salivary secretion. Mastication 
is evidently of great importance in preparing the substances to be 
afterward operated on for the action of their solvent. The com- 
plete separation in parts of the alimentary matter, therefore, is of 
great consequence, and, if imperfectly effected, the subsequent 
processes are liable to derangement. This derangement we con- 
tinually meet with; for there is not, perhaps, a more frequent 
source of dyspepsia than imperfect mastication, whether resulting 
from the haste with which the food is swallowed, or from the want 
of the proper instruments. The disintegration of the food by me- 
chanical reduction is manifestly aided by insalivation ; and the ad- 
mixture of saliva appears further to have the effect of commencing 
the transformation of the starchy particles into sugar. From re- 
cent experiments it would seem that saliva, if acidulated, possesses 
the same power of acting on azotized compounds as that which 
characterizes the gastric juice, and, consequently, when introduced 
into the stomach, the saliva may afford important aid in the digest- 
ive process. When the reduction of the food in the mouth has 
been sufficiently accomplished it is carried into the oesophagus by 
the action of deglutition. The share which the nervous system 
has in this action has been already stated, and it here only remains 
to define more precisely the different movements which are con- 
cerned in it. The first stage in the process is the carrying back 
of the food until it has passed the anterior palatine arch; this, 
which is effected by the approximation of the tongue and the palate, 
is a purely voluntary movement. In the second stage the tongue 
is carried still further backward, and the larynx is drawn forward 
under its root, so that the epiglottis is depressed down over the 
rima glottidis. The muscles of the anterior palatine arch contract 
after the morsel has passed it, and assist its passage backward ; these, 
with the tongue, cut off completely the communication between the 
fauces and the mouth. At the same time, the muscles of the pos- 
terior palatine arch contract in such a manner as to cause the 
sides of the arch to approach each other like a pair of curtains, so 
that the passage from the fauces into the posterior nares is nearly 
closed by them ; and to the cleft between the approximated sides 



PHYSIOLOGY AND LAWS OF LIFE. 745 

the uvla is applied like a valve. A sort of inclined plane, directed 
obliquely downward and backward, is thus formed, and the morsel 
slides along it into the pharynx, which is brought up to receive it. 
Some of these acts may be performed voluntarily, but the combin- 
ation of the whole is automatic. The third stage of the process, 
the propulsion of the food down the cesophagas, then commences. 
This is accomplished in the upper part by means of the constrict- 
ors of the pharynx, and in the lower by the muscular coat of the 
oesophagus itself. When the morsels are small, and are mixed 
with much fluid, the undulating movements from above downward 
succeed each other very rapidly ; this may be well observed in 
horses while drinking ; large morsels, however, are frequently some 
time in making their way down. Each portion of food and drink 
is included in the contractile walls, which are closely applied to it 
during the whole of its transit. The whole of the third stage is 
completely involuntary. At the point where the oesyophagus enters 
the stomach — the cardiac orifice of the latter — there is a sort of 
sphincter, which is usually closed. This opens when there is a suf- 
ficient pressure on it made by accumulated food, and afterward 
closes so as to retain the food in the stomach. The opening of the 
cardiac is one of the first acts which takes place in vomiting. 

Action of the Stomach. — A remarkable opportunity of ascertain- 
ing the condition of the stomach during digestion presented itself 
some time since, in a case in which a large fistulous aperture re- 
mained after a wound that laid open the cavity, but in which the 
general health was completely recovered, so that the process may 
be considered as having been nominally performed. " The inner 
coat of the stomach, in its natural and healthy state, is of a light 
or pale pink color, varying in its hues, according to its full or 
empty state. It is of a soft or velvet-like appearance, and is con- 
stantly covered with a very thin, transparent, viscid mucus, lining 
the whole interior of the organ. By applying aliment or other 
irritants to the internal coat of the stomach, and observing the 
efi'ect through a magnifying glass, innumerable lucid points and 
very fine nervous or vascular papillae can be seen arising from the 
villous membrane, and protruding through the mucous coat, from 
■which distills a pure, limpid, colorless, slightly viscid fluid. The 
fluid thus excited is invariably distinctly acid. The mucus of the 
stomach is less fluid, more viscid or albuminous, semi-opaque, 
sometimes a little saltish, and does not possess the slightest char- 



746 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

acter of acidity. The gastric fluid never appears to be accumu- 
lated in the cavity of the stomach while fasting, and is seldom, if 
ever, discharged from its proper secerning vessels, except when 
excited by the natural stimulus of aliment, mechanical irritation 
of tubes, or other excitants. When aliment is received the juice 
is given out in exact proportion to its requirements for solution, 
except when more food has been taken than is necessary for the 
wants of the system." That the quantity of the gastric juice se- 
creted from the walls of the stomach depends rather upon the 
general requirements of the system than upon the quantity of 
food introduced into the digestive cavity, is a principle of the high- 
est practical importance, and can not be too steadily kept in view 
in dietetics. A definite proportion only of aliment can be perfectly 
digested in a given quantity of the fluid, the action of which, like 
that of other chemical operations, ceases after having been exer- 
cised on a fixed and definite amount of matter. "When the juice 
has become saturated it refuses to dissolve more ; and, if an excess 
of food has been taken, the residue remains in the stomach, or 
passes into the bowels in a crude state, and becomes a source of 
nervous irritation, pain and disease, for a long time." The unfa- 
vorable efi'ect of an undue burden of food upon the stomach itself, 
interferes with its healthy action, and thus the quantity really 
appropriate is not dissolved. The febrile disturbance is thus in- 
creased, and the mucous membrane of the stomach exhibits evident 
indications of its morbid condition. The description of these indi- 
cations, given by Dr. Beaumont, is peculiarly graphic, as well as 
hygienically important. 

" In disease, or partial derangement of the healthy function, the 
mucous membrane presents various and essentialfy-difierent appear- 
ances. In febrile conditions of the system, occasioned by what- 
ever cause — obstructed perspiration, undue excitement by stimu- 
lating liquors, overloading the stomach with food, fear, anger, or 
whatever depresses or disturbs the nervous system — the villous 
coat becomes sometimes red and dry, at other times pale and moist, 
and loses its smooth and healthy appearance ; the secretions be- 
come vitiated, greatly diminished, or even suppressed ; the coat 
of mucus scarcely perceptible, the follicles flat and flaccid, with 
secretions insufiicient to prevent the papillae from irritation. There 
are sometimes found, on the internal coat of the stomach, erup- 
tions of deep-red pimples, not numerous, but distributed here and 



PHYSIOLOGY AND LAWS OF LIFE. 747 

there upon the Ttllous membrane, rising above the surface of the 
mucous coat. These are at first sharp-pointed and red, but fre- 
quently become filled with white purulent matter. At other times 
irregular circumscribed red patches, varying in size and extent 
from half an inch to an inch and a half in circumference, are found 
on the internal coat. These appear to be the efi'ects of conges- 
tion in the minute blood-vessels of the stomach. There are also 
seen at times small aphthous crusts in connection with these red 
patches. Abrasion of the lining membrane, like the rolling up of 
the mucous coat into small shreds or strings, leaving the papillae 
bare for an indefinite space, is not an uncommon appearance. 
These diseased appearances, when very slight, do not always affect 
essentially the gastric apparatus. When considerable, and partic- 
ularly when there are corresponding symptoms of disease — as dry- 
ness of the mouth, thirst, accelerated pulse, etc. — no gastric juice 
can he extracted by tlie alimentary stimulus, Drinks are imme- 
diately absorbed or otherwise disposed of; but food taken in this 
condition of the stomach remains undigested for twenty-four or 
forty-eight hours, or more, increasing the derangement of the ali- 
mentary canal, and aggravating the general symptoms of disease. 
After excessive eating or drinking chymification is retarded, and, 
though the appetite be not always impaired at first, the fluids be- 
come acrid and sharp, excoriating the edges of the aperture, and 
almost invariably producing aphthous patches and the other indi- 
cations of a diseased state of the internal membrane. Vitiated 
bile is also found in the stomach under these circumstances, and 
fiocculi of mucus are more abundant than in health. Whenever 
this morbid condition of the stomach occurs, with the usual accom- 
panying symptoms of disease, there is generally a corresponding 
appearance of the tongue. When a healthy state of the stomach 
is restored, the tongue invariably becomes clean." 

The food which is propelled along the oesophagus enters the 
stomach through its cardiac orifice in successive waves, and it is 
immediately subjected to a peculiar peristaltic movement, which 
has for its object to produce the thorough intermixture of the gas- 
tric fluid with the alimentary mass, and also to aid the solution of 
the latter by the gentle trituration to which it is thus subjected. 
The fasciculi composing the muscular wall of the human stomach 
are so disposed as to shorten its diameter in ev£ry direction, and 
by the alternate contraction and relaxation of these bands a great 



748 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

variety of motion is induced in this organ, sometimes transversely, 
and at other times longitudinally. " These motions," Dr. Beau- 
mont remarks, " not only produce a constant disturbance or churn' 
ing of the contents of the stomach, but they compel them, at the 
same time, to revolve about the interior from point to point, and 
from one extremity to the other." In addition to these move- 
ments, there is a constant agitation of the stomach, produced by the 
respiratory muscles. The motions of the stomach itself are not 
performed on any very exact plan, and are much influenced by the 
character of the food, the state of the general system, and by other 
circumstances. These motions continue until the stomach is per- 
fectly empty, and not a particle of food or chyme remains. Of the 
degree in which they are dependent upon the influence of the nerv- 
ous system some idea has been already given ; there is yet much 
to be learned, however, especially in regard to the degree in which 
the movements may be checked or altered by impressions trans- 
mitted through the nervous system. It is stated by Brachet that, 
in some of his experiments upon the par vagum some hours after 
section of the nerve on both sides, the surface only of the aliment- 
ary mass was found to have undergone solution, the remainder of 
the mass remaining in the condition in which it was first ingested ; 
and if this statement can be relied on, it would appear that the 
movements of the stomach, like those of the heart, can be readily 
affected by a strong nervous impression. It may be partly in this 
manner, therefore, and not by acting upon the secretions alone, 
that strong emotions influence the digestive process as they are 
well known to do. On the other hand, the moderate excitement 
of pleasurable emotions may be favorable to the operation, not 
only by giving firmness and regularity to the action of the heart, 
and thence promoting the circulation of the blood and the increase 
of the gastric secretion, but also in impairing firmness and regu- 
larity to the muscular contractions of the stomach. 

Action of the Intestinal Tube. — The pulpy substance to which 
the food is reduced, by the mechanical reduction and chemical so- 
lution it has undergone in the mouth and stomach, is termed chyme. 
The consistence of this will, of course, vary in some degree with the 
the quantity of fluid taken in ; in general it is greyish, semifluid, 
and homogeneous, and possesses a slightly acid taste, but is other- 
wise insipid. Dr. Beaumont describes it as varying in its aspect — 



PHYSIOLOGY AND LAWS OF LIFE.' 749 

from that of cream, which it presents when the food has been of 
a rich character, to that of gruel, which it possesses when the 
diet has been farinaceous. The passage of the chyme through the 
pyloric orifice is at first slow ; but w^hen the digestive process is 
nearly completed, it is transmitted in much larger quantities. 
From the time that the ingested matter enters the intestinal canal, 
it is propelled by the simple peristaltic action of its muscular coat, 
which is directly excited by the contact either of this matter or of 
the secretions which are mingled with it, and all that is not absorbed 
is thus conducted to the rectum, its expulsion from which is due 
to an action of a distinctly reflex kind, excited through the nervous 
centers. During its progress through the intestinal tube, the pro- 
duct of the gastric operation undergoes very important changes. 
The chyme is mingled in the duodenum with the biliary and pan- 
creatic secretions, which efi*ect an immediate alteration both in its 
sensible and chemical properties. The naturS of this alteration 
can be best estimated by mingling bile with chyme removed from 
the body. This has been done by several experimenters on the 
lower animals, and by Dr. Beaumont, in the case already referred 
to, which afi'orded him the means of obtaining not only chyme but 
bile and pancreatic fluid. The eff'ect of this admixture was to 
separate the chyme into three distinct parts, a reddish brown sed- 
iment at the bottom, a whey- colored fluid in the center, and a 
creamy pellicle at the top. The central portion, with the creamy 
pellicle, seems to constitute the chyle absorbed by the lacteals, the 
creamy mdtter being chiefly composed of oily particles, and the 
wheyey fluid having proteine-compounds, saccharine and saline 
matters, in solution ; the sediment partly consisting of the insolu- 
ble portion of the food, and partly of the biliary matter itself, is 
evidently excrementitious. 

By the gradual withdrawal of their fluid portion, the contents of 
the alimentary canal are converted into a mass of greater consist- 
ence, and this, as it advances through the small intestines, assumes 
more and more of a faecal character. A part of the fseces, how- 
ever, may be derived from the secretions of the enteritic mucous 
membrane, and of its glandulse; the surface of the former, with 
its simple follicles, probably secretes nothing else than mucus; 
but the glandulce, with which it is so thickly studded, appear to 
serve as the channel for the elimination of putrescent matter from 
the blood. There can be no doubt that a large quantity of fluid 



750 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

is poured out by these glandulse when they are in a state of irrita- 
tion from disease or from the stimulus of a purgative medicine, 
since the amount of water discharged from the bowels is often 
much greater than that which has been taken in, and must be de- 
rived from the blood. 

Nature of Chymification and CTiylification. — The causes of the 
reduction of the food in the stomach have long been a fruitful 
source of discussion among physiologists, and various hypotheses 
have been devised to account for it. Some have compared the 
stomach of man to the gizzard of a fowl, and have supposed that 
the tritwation or grinding of the food between its walls w^as the 
essential element in the process ; but this doctrine is completely 
incompatible with the fact that digestible substances, inclosed in 
metallic balls with perforations in their sides, are still dissolved by 
the power of the gastric fluid, though the walls of the stomach do 
not come in contact with them. Others, again, have imagined that 
the process of digestion is one of putrefaction ; but this idea, put- 
ting aside its inherent absurdity, is proved to be incorrect by the 
fact that the gastric juice has a decidedly antiseptic quality. 
Others, in despair of obtaining any other solution, have attributed 
the operation to the direct agency of the vital principle, forgetting 
that, as long as the food remains within the stomach and intestinal 
canal, it can no more be the subject of any peculiarly vital process 
than if it were in contact with the skin, of which the mucous mem- 
brane is but an internal reflection. The theory of chemical solu- 
tion, which was at first regarded by many as quite untenable, has 
been of late years so much strengthened by new facts and argu- 
ments, that there now appears no valid reason for withholding our 
assent from it, even though it can not yet give a complete explana- 
tion of the complex phenomena in question. The chief opposition 
to this theory has arisen from the difiiculty of imagining that any 
simply chemical solvent should have the power of acting on so 
great a variety of substances and of reducing them to a state so 
homogeneous. This difficulty, however, seems now in a great de- 
gree removed, by the discovery of the close chemical relation that 
subsists between the various substances of each of the groups al- 
ready enumerated, which renders it easy to conceive that the changes 
involved in their reduction may be of a very simple characte. 

The first series of facts which will be here adduced, as throwing 



PHYSIOLOGY AND LAWS OF LIFE. 751 

light on the process of chymification, is that which has been ob- 
tained by the experiments of Dr. Beaumont upon Alexis St. Mar- 
tin. By introducing a tube of India-rubber into the empty stomach, 
he was able to obtain a supply of gastric juice whenever he desired 
it; for the tube served the purpose of stimulating the follicles to 
pour forth their secretion, and, at the same time, conveyed it away. 
This fluid, of which the existence has been denied by some phys- 
iologists, is not very unlike saliva in its appearance ; it is, how- 
ever, distinctly acid to the taste, and chemical analysis shows that 
it contains a considerable proportion of free muriatic acid, and 
also some acetic acid. The former must evidently be derived from 
the decomposition of the muriate of soda contained in the blood, 
the remote source of which is the salt taken with the food. The 
latter is an organic compound, probably formed at the expense of 
some of the saccharine matter of the previous aliment. Of equal 
importance with the free acids, is an animal matter, soluble in cold 
"vvater, but insoluble in hot, bearing considerable resemblance to 
albumen. Of this more will be said hereafter. Besides these prin- 
cipal ingredients, the gastric fluid contains muriates and phosphates 
of potass, soda, magnesia, and lime. • It possesses the power of 
coagulating albumen in an eminent degree ; it is powerfully anti- 
septic, checking the putrefaction of meat; and it is efl"ectually re- 
storative of healthy action when applied to old fetid sores and foul 
ulcerating surfaces. It may be kept for many months, if excluded 
from the air, without becoming fetid. 

The gastric juice obtained from the stomach was found by Dr. 
Beaumont to possess the power of dissolving various kinds of ali- 
mentary substances, when these were submitted to its action at a 
constant temperature of 100° (which is about that of the stomach), 
an.d were frequently agitated. The solution appeared to be, in all 
respects, as perfect as that which naturally takes place in the stom- 
ach, but required a longer time. This is readily accounted for 
w^hen we remember that no ordinary agitation can produce the 
same eff'ect with the curious movements of the stomach, and that 
the continual removal from its cavity of the matter which has been 
already dissolved must aid the operation of the solvent on the re- 
mainder. The following is one out of many experiments detailed 
by Dr. Beaumont. " At half-past eleven o'clock A. M., after hav- 
^ing kept the lad fasting for seventeen hours, I introduced a gum- 
elastic tube, and drew ofi" one ounce of pure gastric liquor, unmixed 



752 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

with any other matter, except a small proportion of mucus, into a 
three-ounce phial. I then took a solid piece of boiled recently-salted 
beef, weighing three drachms, and put into the liquor in the phial; 
corked the phial tight, and placed it in a saucepan filled with water, 
raised to the temperatm'e of 100°, and kept at that point on a 
nicely-regulated sand-bath. In forty minutes digestion had dis- 
tinctly commenced over the surface of the meat. In fifty minutes 
the fluid had become quite opaque and cloudy ; the external texture 
began to separate and become loose. In sixty minutes chyme be- 
gan to form. At one o'clock P. M., (digestion having progressed 
with the same regularity as in the last half hour,) the cellular text- 
ure seemed to be entirely destroyed, leaving the muscular fibers 
loose and unconnected, floating about in fine small shreds, very 
tender and soft. At three o'clock the muscular fibers had dimin- 
ished one half, since the last examination. At five o'clock they 
were nearly all digested, a few fibers only remaining. At seven 
o'clock the muscular texture was completely broken down, and only 
a few of the small fibers could be seen floating in the fluid. At 
nine o'clock every part of the meat was completely digested. The 
gastric juice, when taken from the stomach, was as clear and trans- 
parent as water. The mixture in the phial was now about the color 
of whey. After standing at rest a few minutes, a fine sediment, 
of the color of the meat, subsided to the bottom of the phial. A 
piece of beef, exactly similar to that placed in the phial, was intro- 
duced into the stomach, through the aperture, at the same time. At 
twelve o'clock it was withdrawn and found to be as little affected 
by digestion as that in the phial ; there was little or no difference 
in their appearance. It was returned to the stomach, and, on the 
string being drawn out, at one o'clock P. M., the meat was found 
to be all completely digested and gone. The effect of the gastric 
juice on the piece of meat suspended in the stomach was exactly 
similar to that in the phial, only more rapid after the first half hour, 
and sooner completed. Digestion commenced on, and was con- 
fined to, the surface entirely in both situations. Agitation accel- 
erated the solution in the phial by removing the coat that was di- 
gested on the surface, enveloping the remainder of the meat in the 
gastric fluid, and giving this fluid access to the undigested portions." 
Many variations were made in other experiments, some of which 
strikingly displayed the effects of thorough mastication in aiding^ 
both natural and artificial digestion. 



PHYSIOLOGY AND LAWS OF LIFE. 753 

The attempt was made by Dr. Beaumont to determine the rela- 
tive digestibility of different articles of diet, by observing the 
length of time requisite for their solution. But, as he himself 
points out, the rapidity of digestion varies so greatly, according to 
the quantity eaten, the nature and amount of the previous exercise, 
the interval since the preceding meal, the state of health, the con- 
dition of the mind, and the nature of the weather, that a much 
more extended inquiry would be necessary to arrive at results to 
be depended on. Some important inferences of a general charac- 
ter, however, may be drawn from his inquiries. It seems to be a 
general rule that the flesh of wild animals is more easy of diges- 
tion than that of the domesticated races which approach them most 
nearly. This may, perhaps, be partly attributed to the small quan- 
tity of fatty matter that is mixed up with the flesh of the former, 
while that of the latter is largely pervaded by it ; for it appears, 
from Dr. Beaumont's experiments, that the presence in the stomach 
of any substance which is diflicult of digestion interferes with the 
solution of food that would otherwise be soon reduced. It seems 
that, on the whole, beef is more speedily reduced than mutton, and 
mutton sooner than either veal or pork. Fowls are far from pos- 
sessing the digestibility that is ordinarily imputed to them ; but 
turkey is, of all kinds of flesh, except venison, the most soluble. 
Dr. Beaumont's experiments further show that hulk is as neces- 
sary for healthy digestion as the presence of the nutrient princi- 
ple itself. This fact has been long known by experience to unciv- 
ilized nations. The Kamschatdales, for example, are in the habit 
of mixing earth or sawdust with the train-oil, on which alone they 
are frequently reduced to live. The Yeddahs, or wild hunters of 
Ceylon, on the same principle, mingled the pounded fibers of soft 
and decayed wood with honey, on which they feed when meat is 
not to be had ; and on one of them being asked the reason of the 
practice, he replied, " I can not tell you, but I know that the belly 
must be filled." It is further shown by Dr. Beaumont that soups 
and fluid diet are not more readily chymified than solid food, and 
are not alone fit for the support of the system ; and this, also, is 
conformable to the well-known results of experience ; for a dys- 
peptic patient will frequently reject chicken-broth when he can 
retain solid food or a richer soup. Perhaps, as Dr. A. Combe re- 
marks, the little support gained from fluid diet is due to the rapid 
absorption of the watery part of it, so that the really nutritious 
48 



754 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

portion is left in too soft and concentrated a state to excite the 
healthy action of the stomach. Dr. Beaumont also ascertained 
that moderate exercise facilitates digestion, though severe and 
fatiguing exercise retards it. If even moderate exercise be taken 
immediately after a full meal, however, it is probably rather inju- 
rious than beneficial ; but if an ho.ur be permitted to elapse, or if 
the quantity of fo.od taken have been small, it is of decided benefit. 
The influence of temperature on the process of solution is remark- 
ably shown in some of Dr. Beaumont's experiments. He found 
that the gastric juice had scarcely any influence on the food sub- 
mitted to it, when the bottle w^as exposed to the cold air, instead 
of being kept at a temperature of 100°. He observed, on one oc- 
casion, that the injection of a single gill of water at 50° into the 
stomach sufficed to low^er its temperature upward of 30°, and that 
its natural heat was not restored for more than half an hour. 
Hence, the practice of eating ice after dinner, or even of drinking 
largely of cold fluids, is very prejudicial to digestion. 

From the foregoing statements, we may conclude that the pro- 
cess by which the' food is dissolved in the gastric fluid is of a purely 
chemical nature, since it takes place out of the living body as well 
as in it, allowance being made for the diff"erence in its physical 
condition. Thsit the natural process of digestion is imitated when 
the food is submitted to the action of the gastric juice in a phial, 
not only in regard to the disintegration of its particles, but as to 
the change of character which they are made to undergo, is proved 
by the fact that the artificial chyme thus formed exhibits the same 
changes as the real chyme when submitted to the action of the bile. 
The process of digestion, however, may be freely conceded to be 
vital, in so far as it is dependent upon the agency of a secreted 
product, which vitality alone (so far at least as we at present know) 
can elaborate ; and all for which it is here contended is, that, when 
this product is once formed, it has an agency upon the alimentary 
matter, which, though not yet fully understood, is conformable in 
all that is known of its operation to the ordinary laws of chemistry. 
Thus, digestion is conformable to chemical solution, first, in the as- 
sistance which both derive from the minute division of the solids 
submitted to it ; secondly, in the assistance which both derive from 
the successive addition of small portions of the comminuted solid 
to the solvent fluid, and from the thorough intermixture of the two 
by continual agitation ; thirdly, in the limitation of the quantity 



PHYSIOLOGY AND LAWS OF LIFE. 755 

of food on which a given amount of gastric juice can operate, which 
is precisely the case with chemical solvents ; fourthly, in the assist- 
ance which both derive from an elevation of temperature, the bene- 
ficial influence of heat being only limited, in the case of digestion, 
by its tendency to produce decomposition of the gastric fluid*; 
fifthly, in the difi'erent action of the same solvent upon the various 
solids submitted to it. 

We have, in the last place, to consider the changes which are 
effected in the nutritive materials by the admixture of the biliary 
and pancreatic secretions, and to inquire into the form in which 
they are received into the absorbent vessels. The substances of 
the first or saccharine group consist chiefly of sugar and starch. 
It appears, from the late researches of MM. Bouchardat and San- 
dras, that sugar, is gradually converted, during its passage along 
the alimentary canal, into lactic acid; and that it is absorbed in 
this form alone, unless it have been administered in considerable 
quantity or for a long period. The conversion of sugar into lac- 
tic acid, appears to be preliminary to the elimination of that sub- 
stance by the respiratory process. The particles of starch, as 
already mentioned, are but very little acted on by the digestive 
process, at least in man and the mammalia, unless their envelopes 
have been previously ruptured by heat or chemical agents ; but 
the triturating power of the gizzard in granivorous birds, aided by 
the high temperature and the more alkaline character of the secre- 
tions, enables them to act with more energy upon amylaceous sub- 
stances. The products of the digestive action upon starch are 
dextrine and grape-sugar, and this is gradually converted into lac- 
tic acid, in which state it is absorbed. If sugar be introduced into 
the blood-vessels unchanged, it is drawn off by the urine, and its 
heat-sustaining agency, therefore, is not exerted. It is probably 
to avoid its too rapid introduction that the conversion of amyla- 
ceous into saccharine matter is so slowly effected in the alimentary 
canal.^ this conversion seems to begin in the mouth, to cease in the 
stomach during the operation of the acid solvent, and to recom- 
mence after the neutralization of the acid by the bihary and pan- 
creatic fluids, subsequently continuing during nearly the whole of 
the passage of the alimentary matter along the intestinal tube. It 
is now quite certain that the substances of this class may be con- 
verted, in the living body, into oleaginous matter. Of the mode 
and the situation in which this conversion takes place, nothing 



756 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

whatever is certainly known, but a clue to an acquaintance with 
the former seems to be given by the recently-discovered fact that 
the continued contact of bile with saccharine matter occasions the 
conversion of a portion of the sugar into an adipose compound. 

The substances forming the oily oleaginous class do not seem to 
undergo any change, except minute division of their particles, until 
the chyme is mingled with bile, which substance acts as a soap, 
and renders the oily matters soluble, or at any rate reduces them 
to a condition in which they can be absorbed by the lacteals. This, 
indeed, seems to be the main purpose of that admixture of the bile 
with the mass in process of digestion, which experiments and path- 
ological observation abundantly prove to be requisite for the due 
performance of that function. Thus, it has been show^n, by the 
experiments of Schwann, that if the bile duct be divided, and be 
made to discharge its contents externally through a fistulous ori- 
fice in the walls of the abdomen, instead of into the intestinal canal, 
those animals which survive the immediate effects of the operation 
subsequently die from inanition, almost as soon as if they had been 
entirely deprived of food. In like manner, if the flow of the biliary 
secretion into the intestine be prevented by disease — such as ob- 
struction of the gall duct — the digestive function is evidently 
disordered, the peristaltic action of the intestine is not duly per- 
formed, the faeces are white and clayey, and there is an obvious 
insufficiency in the supply of nutriment prepared for the absorbent 
vessels. This deficiency seems partly due to the want of power 
to absorb the oleaginous particles of the food, which is the result 
of the non-intermixture of the bile with the chyme, and partly to 
the suspension of the supply of combustible matter that is afforded 
by certain constituents of the bile itself, which are destined not to 
be carried out of the system, but to be reabsorbed. The presence 
of bile in the stomach has the effect of suspending the solution of 
the various azbtized principles, and in regard to them, therefore, 
it is injurious ; but it seems, from the observations of Dr. Beau- 
mont, to be a spontaneous occurrence, whenever the diet has been 
for a long time, and in great part, of an oleaginous nature ; and it 
then appears destined to aid in the producing process, which is the 
proper function of the stomach. It is suggested, by Dr. A. Combe, 
whether the peculiar digestibility of a piece of fat bacon, in certain 
forms of dyspepsia, may not be due to the abnormal presence of 
bile in the stomach. The power of precipitating the proteine com- 



PHYSIOLOGY AND LAWS OF LIFE. 757 

pounds from their acid solutions, which has been shown, by the re- 
cent experiments of Platner, to belong to the peculiar principles 
of bile, fully explains its injurious effects upon the solvent pro- 
cesses which normally take place in the stomach. In regard to 
the albuminous and gelatinous articles of food, there is no evidence 
that any other change is effected in them than one of simple solu- 
tion ; and they appear to be absorbed in the same condition as that 
to which they are reduced by the action of the stomach. 



GLOSSAEY 



OF 



MEDICAL AND SCIENTIFIC TERMS. 



Abraded — Having the skin rubbed off. 

Absorbent — That which absorbs, or soaks up. 

Abdomen — The belly. 

AcARUS — An itch insect. 

Acescent — Disposed to acidity. 

Acidulated — Rendered slightly acid or sour. 

ACRID^ — Of a hot, biting taste when taken internally, or causing heat 

and irritation of skin if applied outwardly. 
Ad libitum — To an indefinite extent. 
Aerated — Purified by fresh air. 
Aeeusion — The pouring of liquid on a body. 
Albumen — A sample is found in the white of an egg. 
Aliment — Food. 

Alluvium — The matter left after a freshet has subsided. 
Alkaline — Deprived of carbonic acid. 
Alteratives — Medicines supposed to bring about a salutary change 

in a disease. 
Alvine — Relating to the lower belly. 
Amylaceous — Having the nature of starch. 
Anaesthesia — Loss of feeling. 
Anasarca — Dropsy of the cellular membrane. 
Animalcule — A very small animal. 
Anodynes — Medicines which relieve pain. 
Antacids — Remedies which remove acidity of the stomach. 
ANTHELMiNTics^Remedies for worms. 
Antidotes — Medicines which act against poisons. 
Antiscorbutic — Opposed to scurvy. 

Apoplectic — Disposed to or having the character of apoplexy. 

759 



760 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Apathy — Accidental suspension of tlie moral feelings. 
Aperient — A medicine which acts on the bowels gently. 
Areola — The colored circle surrounding the nipple. 
Aromatics — Medicines stimulating and fragrant. 
Articulation — The union of one bone with another. 
Asphyxia — Apparent death, from drowning, hanging, etc. 
Astringents — Eemedies of a "binding" nature. 
Atony — Weakness of every organ. 

Atrophy — A lessening of the whole or any part of the body 
Auscultation— The art of sounding the lungs by listening. 

Bassorine — A gum from a plant growing on the Grulf of Persia. 
Bile — A fluid given out by the liver, 
BiLiNE — An ingredient of bile. 
BioPHOBiA — Dread of loss of life. 

Bougie — A flexible cylinder introduced into the urethra, oesopha- 
gus, etc., to open them when contracted. 
Bronchia — The two tubes which carry air to the lungs 

Caffeine — An active principle of coffee. 

Calculus — A formation found principally in the bladder. 

Calcareous — Containing lime. 

Calorific — Producing heat. 

Caloric — Heat. 

Capillary — Hair-like. 

Capsule — A covering, as a shell or bag. 

Carminatives — Remedies which drive wind from the bowels, reliev- 
ing pain thereby. 

Carnivorous — Flesh-eating. 

Caseine — The cheesy ingredient of milk. 

Cataplasm — A poultice. 

Cathartics — Medicines which increase the discharges from the 
lower bowels. 

Catheter — An instrument for drawing water from the bladder. 

Cauterize — To burn with caustic. 

Cartilage — A substance to be found at the joint and ends of the ribs. 

Cardiac — Relating to the heart or to the upper orifice of the stomach. 

Cellular — Composed of cells. 

Cerate — A composition of wax and lard. 

Cerebral — Belonging to the brain. 

Chalybeate — Containing iron. 

Cholesterine — An ingredient of certain kinds of calculi found in 
the bile. 



GLOSSARY OF MEDICAL AND SCIENTIFIC TERMS. 761 

Chyle — A whitish fluid drawn from food by the absorhent vessels 

of the bowels. 
Chyme — The result produced by the action of the stomach and its 

juices on food. 
Chiropodist — One who treats diseases of the hands or feet. ^ 
Cicatrized — Healed and scarred. 
Ciliary — Relating to the eye-lashes. 
CoAGULUM — In blood, a clot; in milk, a curdled mass. 
Colander — A vessel for straining liquors. 

Colliquative discharges are those producing rapid exhaustion. 
Colorific — Producing color. 
Colostrum — The first milk after child-birth. 
CoLLYRiUM — Eye-water. 
Clysters — Injections by syringe. 
Colon — A portion of the large intestines or bowels. 
Confluent — Running together. 
Congenital — Occurring at birth. 
Coma — A state of unnatural sleep. 
Congestion — Accumulation of blood in an organ. 
Consistency — Density. 
Constriction — A drawing together. 
Cornea — A transparent coat of the eye. 
Cordials — Medicines used for exciting the lieart. 
Counter-irritants — Remedies used for causing an irritation in one 

part to relieve one existing in another part. 
Coup de Soliel — Sun-stroke. 
Cranium — The skull. 
Cutaneous — Pertaining to the skin. 
Cuticle — The outer or scarf-skin. 
Cystine — Belonging to the gall-bladder. 

Debilitant — A remedy which reduces excitement. 

Decoction — The operation of boiling certain ingredients in a fluid 

to get the soluble parts. 
Deglutition — The act of swallowing. 
Demulcents — Medicines which protect the sensitive parts of the 

body. 
Dentition — Teething . 
Depletion — The act of emptying. 
Depilatory — That which causes loss of hair. 
Derivative — Medicine which, by producing a modified action in an 

organ, relieves the disease in some other organ. 
Desquamation — Scaling off. 



762 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Dextrine — Britisli gum. 

Diabetes — A morbid and increased discliarge of urine. 

Diagnosis — The art of telling the nature of disease. 

Diaphoretic — Promoting perspiration. 

Diathesis — Constitution. 

Diluents — Medicines which increase the fluids of the body 

Discutients — Remedies employed against tumors. 

Disinfectants — Agencies used to subdue or destroy the influence 

of miasms. 
Diuretic — Medicine having the power of increasing the flow of 

urine. 
Douche — A jet of water thrown on some diseased part of the body. 
Diastase — A vegetable principle. 
Diuresis — A copious flow of urine 
Duct — Canal. 

Duodenum — The first part of the alimentary canal. 
Dysury — Difficulty of passing urine. 
Dyspncea — Difficulty of breathing. 

Effervescence — The agitation produced by the escape of gas 
through a liquid. 

Effluvia — Miasms from marshy ground. 

Electro-galvanism — Electricity produced by the voltaic pile, or 
galvanic battery. 

Electuary — A medicinal preparation. 

Embrocation — Liniment. 

Emetic — That which produces vomiting. 

Emollient — Used to soften inflamed parts. 

Empiric — A charlatan or quack. 

Emulsion — A milky-white preparation of oil and water held in sus- 
pension by mucilage. 

Endemic — That which is due to some peculiarity of soil or locality. 

Enema — Injection. 

Enucleate — To remove a tumor without cutting into it. 

Enuresis — Involuntary discharge of urine. 

Epigastrium — Pit of the stomach. 

Epiglottis — Yalve at the top of the wind-pipe. 

Eructation — Belching. 

Erythema — Erysipelas — rose-rash. 

Exacerbation — Paroxysm, or attack. 

Excretions — Discharges from the body of useless matter. 

Excrementitious — Applied to discharges from the bowels 

Exfoliation— Scaling off. 



GLOSSARY OF MEDICAL AND SCIENTIFIC TERMS. 763 

Exhalations — Vapors. 

Extravasations — Matter or fluids let out of tlie proper vessels. 

Expectorants — Medicines wliieli promote the raising of pUegm. 

F^CES — Discharges from the bowels. ..- 

Farinaceous — Containing farina. 

Fauces — The throat — back part of the mouth. 

Febrile — Relating to fever. 

Fermentation — " Working " of liquors. 

Fetid — Having a bad smell. 

Fiber — A component part of all animal and vegetable textures. 

FiBRiNE — An immediate animal principle. 

Flaccid — Soft and yielding. 

Flatus — Wind in the bov^els. 

Flocculi — Certain fleecy membranes. 

FcETOR— A bad smell. 

Follicles — Small bags. 

Fomentation — A partial bathing by means of cloths dipped in hot 

water and wrung out. 
Fucus — Paint. 
Fume — Smoke, vapor. 
Functional — Relating to functions of an organ. 

Galvanism — Electricity produced by contact of two or more metals, 

or by chemical action. 
GtAnglionics — Medicines used to cure ganglions. 
GtANGRENE — Mortification. 
Gargle — A liquid medicine applied to the throat and then thrown 

out. 
Gastric — Belonging to the stomach. 
Gelatine — Jelly. 
Gelatinous — Jelly-like. 

Genito-urinary — Relating to the urinary and genital apparatus. 
Gestation — The period of pregnancy. 
Globular — Round. 

Glottis — A small oblong opening in the larynx. 
Gluten — An ingredient of wheat flour. 
Graminiverous — Feeding on grass. 
Granular — Grain-like. 

Hemoptysis — Bleeding of the lungs. 

Hectic — A slow fever of irritation and debility. 

Hemiplegia — Paralysis of one side of the body. 



764 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Hemorrhage — Bleeding. 

Hepatic — Belonging to the liver. 

HERBivOROUS-^Feeding on herbs. 

Humid — Moist. 

Humoral — Proceeding from the humors. 

Hydrocephalous — Water in the head. 

Hygrometric — Pertaining to the measurement of the amount of 

watery vapor in the atmosphere. 
Hypertrophy — Unusual bulk of any part of the body. 
Hypochondriasis — A condition of mind wherein persons suppose 

themselves sick. 
Hysteria — Hysterics of women. 

Ichor — The watery part of blood. 

Ileus — Strangulated hernia or nervous colic. 

Iliac Passion — Strangulated hernia. 

Incubation — The act of hatching. 

Indurated — Hard from inflammation. 

Infusoria — Microscopic animals living in water and other liquids. 

Infusion — The pouring of a hot or cold liquid on a substance, to 

extract thereby its virtues. 
Inhalation — Breathing in. 
Injected — Cast inwardly (applied to eyes). 
Inoculation — The introduction of a disease, generally small-pox, 

by artificial means. 
Insalivated — Food mixed with saliva. 
Insulate — To separate from other substances. 
Integument — Skin. 

Interlobular — Between the lobes of the lungs. 
Intermittent — That which has intermissions. 
Ischuria — Retention of urine. 
Issues — Small ulcers produced by art. 

Laminated — Composed of thin leaves. 

Larynx — The organ of voice. 

Latent — Concealed. 

Lavement — An injection. 

Laxative — A medicine which opens the bowels gently. 

Lenitive — A medicine that palliates disease. 

Lesions — Derangements, disorders. 

Ligament — The strong substance which holds bones together at the 

joints. 
Ligature — A cord or thread used to prevent bleeding. 



GLOSSARY OF MEDICAL AND SCIENTIFIC TERMS. 765 

Line — Tlie twelfth part of an incli. 

LiTHiASis — Gravel. 

LiTHic — Belonging to stone. 

Lochia — A thin bloody fluid from the womb after delivery. 

Lotion — An outward fluid application. 

Lumbago — Rheumatism in the loins. 

Lymph — The fluid contained in the lymphatics. 

Macerate — Softening by soaking in some liquid. 

Malaria — See Miasm. 

Mastication — The act of chewing. 

Maximum — The greatest amount. 

Membrane — A thin, white, flexible skin. 

Menses — The monthly flow of women. 

Mesentery — A membrane attached to and holding the bowels in 

place. 
Mesenteric — Relating to the mesentery. 
Metastasis — A condition in which a disease is considered to change 

its location. 
Miasm — An emanation from the earth in marshy places. 
Miasmatic — Afi'ected by miasms. 
Miliary — Resembling millet-seed. 
Minimum — The smallest amount. 
Morbid — Diseased, unnatural. 
Morbific — Causing disease. 
Moribund — In a dying condition. 
Mucilaginous — Gummy. 

Muco-PURIFORM — Having qualities of mucus and pus. 
Mucous — Containing mucus. 
Mucus — A substance of the body resembling mucilage. 

Narcotics — Substances which stupefy. 

Negus — A mixture of wine, lemon -juice, and water. t 

Nephralgia — Pain and neuralgia in the kidney. 

Nephritis — Bright's disease of the kidneys. 

Neuropathy — Diseases of the nervous system. 

Non-ascescent — Not disposed to acidity. 

Nucleus — A body around which any thing is collected. 

Obesity — Extreme corpulency. 
Octahedral — Having eight equal sides. 
(Edema — Swelling of the face. 
Oleaginous — Oily. 



^Q6 AMERICAN HOUSEHOLD BOOK OF MEDICINE 

Omniyorofs — Applied to animals wliicli eat every kind of food. 

Opaque — Not transparent. 

Opiates — Medicines wliicli produce sleep. 

Ossification — The process of changing to bone. 

Ova — Eggs. 

Ovaries — The places where eggs are formed. 

Ovum — An egg. 

Oxidation — The process of changing to an- oxide. 

Oxygenated — Supplied with oxygen. 

Palliative — A remedy or treatment which merely relieves without 

curing. 
Papilla — Nipples, or eminences similar to nipples. 
Papulous — P^esembling or covered with pimples. 
Paraplegia — Palsy of the lower half of the body. 
Parasite — An animal which lives on another animal. 
Parotid gland — A large gland seated under the ear and near the 

angle of the lower jaw. 
Paroxysm — A periodical fit or attack of a disease. 
Pathology — Knowledge of disease. 
Pectine— The basis of vegetable jelly. 
Pelvis — The bony structure below the abdomen or belly. 
PeriNu^eum — The space between the anus and the genital organs. 
Periosteum — A peculiar fibrous skin or covering of bones. 
Periostitis — Inflammation of the periosteum. 
Peritoneum — A membrane lining the abdomen. 
Phlegmon — Inflammation of the areolar texture. 
Phrenitis — Inflammation of the brain. 
PiCROMEL — A part of the bile. 
Plethoric — Full. 

Pleura — The lining of the lungs and inside of the ribs. 
Post-mortem — After death. 

Pulp — The soft parts of vegetables reduced to a paste. 
Puncture — A wound made by a pointed instrument 
Purulent — Having the character of pus. 
Pustule — An elevation of the skin with an inflamed base. 
Pus— Matter. 

Putrescency — Rottenness. 
Putrid — Impure, rotten. 
Pyrexia — Fever, or a feverish condition. 

Quartan — Taking place every fourth day. 
Quotidian — Taking place every day. 



GLOSSARY OF MEDICAL AND SCIENTIFIC TERMS. 767 

Rabies — Madness. 

Keaction — Activity following any diseased influence on tte nervous 

system. 
Rectum — The termination of the intestines. 
Regurgitation — The rising of solids or fluids into the mouth. 
Remittent — Having alternate increase and decrease. 
Renal — Relating to the kidneys. 
Rennet — Curdled milk found in the fourth stomach of a sucking 

calf. 
Repletion — Fullness. 
Resinous — Containing resin. 
Resolution — Return to a healthy condition. 
Rigors — Chills, shiverings. 
Rosaceous — Resembling a rose. 
Rumination — Chewing food the second time, after having been 

swallowed. 

Saccharine — Sugary. 

Saline — Salty. 

Saliva — Spit. 

Salivary — Relating to or forming spit. 

Salivation — An increased flow of saliva. 

Sanguineous — Bloody. 

ScALL — Scab. 

Scarify — To make a small cut into the skin with a lancet or other 

instrument. 
Sciatica — Rheumatism of the hip. 
Scorbutic — Relating to scurvy. 
Scrotum— The bag containing the testicles. 
Sebaceous — Having the nature of suet. 

Secretions — The separation of the blood into various matters. 
Secretory — That which secretes. 

Sedatives — Medicines which depress or lower the vital forces. 
Sedentary — Sitting much._ 
Senile — Belonging to old age. 
Serous — Thin, watery. 

Serum — The watery part of blood and milk. 
Seton — (The operation consists in taking a fold of skin and passing 

a seton-needle through with a thread attached.) 
Sinus — A long, narrow, hollow track leading from some abscess or 

diseased bone. 
Sluice — A stream of water. 
Soluble — Capable of being dissolved. 



768 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

Solvent — A medicine having the power of dissolving. 

SoRDES — A black matter whicL. collects on the teeth in certain 
fevers. 

Specifics— Medicines said to remove particular diseases. 

Sphincter — A name given to muscles of ring form, which contract 
natural openings. 

Sputa — The matters thrown from the mouth in the act of spitting. 

Sternum — The breast-bone. 

Stethoscope — An instrument for sounding the lungs. 

Stertorious — Loud, as applied to breathing. 

Stimulants — Medicines which excite increased action. 

Stimulus — Any thing which excites the animal economy. 

Stomachic — A medicine which strengthens the stomach. 

Strangury — Great difficulty in passing water. 

Stricture — A contraction of some tube or duct. 

Strumous — Scrofulous. 

Stupor — Diminished activity of the brain. 

Sub-acute — Less than " acute." 

Sub-inflammatory — Mildly inflamed. 

Sudorific — A medicine which causes sweating. 

Suppository — A solid medicine in the form of a cone, to be intro- 
duced into the rectum. 

Symptomatic — That which is a sign of some other disease. 

Syncope — Complete and sudden loss of motion and sensation. 

Tendons — Cords connecting bones and muscles. 

Tenesmus — Frequent, painful, and unsuccessful attempts to evacuate. 

Tertian — Happening every other day. 

Theine — The active principle of tea. 

Thermal — Warm. 

Tissues — The elements which form the various organs of the body. 

Tonics — Medicines which increase the general strength. 

Topical — Local. 

Tortuous — Twisted. 

Tubercle — A tumor in the substance of organs. 

Turbid — Thick and muddy. 

Turgid — Bloated. 

Tympany — Inflammation of the lining membrane of the ear. 

Typhoid — Resembling typhus. 

Typhus — A continued fever. 

Unaerated — Not purified by passing through lungs. 
Urea — An essential part of urine. 



GLOSSARY OF MEDICAL AND SCIENTIFIC TERMS. 769 

Ureter — The passage from the kidneys to the bladder. 
Urethra — The passa2;e from the bladder. 
Uterus — The womb. 

Vacuijm — A space empty of all matter. 

Vagina — The external entrance to the female organs of generation. 

Varicose Veins — Swollen veins. 

Vascular — Relating to the vessels. 

Venery — Sexual intercourse. 

Venesection — Blood-letting. 

Venous — Relating to the veins. 

Ventricle — A cavity. 

Vesication — The formation of blisters. 

Vesicle— A small bladder on the skin filled with humor. 

Vesicular — Belonging to a vesicle. 

Vertebra — The bones of the spinal column. 

Vertigo — A state in which every thing seems to be turning or going 

round. 
Virus — A morbid poison. 
Viscid — Stickj-. 

49 



A GUIDE TO DIAGNOSIS 



COMPLETE INDEX OF SYMPTOMS 



. The following Index is divided into four parts, viz. : Diseases op 
Adults m General ; Diseases Peculiar to Women ; Diseases 
OF Children ; and Effects of the various Poisons on the Sys- 
tem. Each of these parts is arranged alphabetically, so that 
ready 'reference can be made to any symptom. 



HOW TO USE THIS INDEX. 

It is plain to every one that when sickness comes, we can all 
of us notice some two or more marked symptoms. If we look 
for these symptoms in the proper division, we are at once directed 
to the page where the dis-ease may be found fully described and 
treated. For instance, a child " grinds its teeth during sleep," and 
*' sleeps with eyes partly open ; " now, on turning to these symptoms 
in the division Diseases of Children, we learn at once that the 
child has " Disease of the Brain." 

In observing symptoms in general, the attention should be di- 
rected to the various parts of the body which give the earliest 
warnings of disease. These are, usually. 

The Head, Eyes, Tongue, Throat, Pulse, Chest, Heart, 
Breath, Breathing; Discharges from the Mouth, including 
Vomiting; The Skin — its state; The Bowels, and Discharges 

FROM THEM ; ThB EXTREMITIES, THE UrINE, THE StOMACH, WITH 

THE General Appearance of the whole Body. 

(771) 



772 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



Diseases of Adults in General. 



PAGES 



Arms, cramp of. 230 

Ankles, dropsy of 281, 282 

do. do. with puffiness of face 283 

do. swelled 319, 369 

Anxiety 370 

Anus, iutolerable itching of » 246 

Backache 154 

Back, chilly 144, 150 

do. pain in 131, 200, 287 

do. do. near kidneys 187 

do. do. in small of 193, 196 

Barking like a dog 236 

Baldness ' 308 

Bladder, sharp pain in region of 189, 

Bearing down 189, 194 

Belly, colicky pains in 282 

do. contraction of muscles of , 237 

do. distended 139, 242, 282 

do. dropsy of 283, 285 

do. swollen, doughy, and inelastic 319 

do. tender when pressed 314 

Belching ♦. 220 

Breast-bone, sharp pain at lower end of 231 

Breast, tightness across 233 

Breath, shortness of : , 276, 367 

Breath, offensive 200, 243, 303, 319, 350 

Breathing, as if strangling 200 

do. fits of hard 280, 372 

do. stertorious or loud 156, 211 

do. very difficult 178, 181, 233, 281, 283, 370 

Blindness, at night , 316 

do. partial or complete 322 

Blood, coughed up. 275 

do. from nose 206, 371 

do. rush of to head 371 

do. spitting of 277 

Bloody stools 200 

Body, becomes yellow 310 

do. swelled 280 

do. wasting of • 283 



A GUIDE TO DIAGNOSIS. 773 



PAGES 



Bowels, blood from 139, 200, 207 

do. costive , 187 

do. loose 138, 271 

do. noises in , 282 

do. pain on pressure of 139, 186 

do. rice-water discharges from 256 

do. windy distension of 320 

Bubo 203 

Burns 356 

Carus 211 

Clap 378 

Cramp 229 

do. of arms 230 

do. of legs 230, 255 

Chest, oppression in 181, 277 

Chest-bone, weight at lower part of 286 

Chewing, painful 178 

Chilliness 131, 177, 198, 350 

Chill, every 24 hours 145 

do. do. 48 do 145 

do. do. 72 do 145 

do. severe 154, 275 

Chicken-pox , 288 

Chilblains 361 

Cold extremities 138, 220 

Colic '. 237 

Coma 138, 150, 197, 211 

Complexion, sallow 220 

Constipation 131, 156, 171, 220, 271 

Costiveness 186, 220, 239, 271, 318 

Cough, dry and husky 178, 233 

do, dry and tickling 277 

Convulsions 138, 171, 226, 367 

Cholera, Asiatic 253 

Consumption 275 

Corns 300 

Cough, dry and suppressed 139 

Coughing of blood 275 

Countenance, sallow and bloated 303 

do. of a pale, lemon tinge 346 

Dandruff 297 

Deafness 199 



774 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

PAGE3 

Debility, general . 220, 271 

Delirium, on awaking , 367 

do. 131, 138, 155, 171, 197, 200 

Diarrhea 156, 200, 254 

Dizziness 351 

Dropsy of belly 285 

Dropsy .' 326 

Drowsiness 138, 150 

Ears, buzzing in 206 

do. coldness of. 150 

do. ringing in 243, 317 

do. swellings under 178 

Emaciation 346 

Expectoration, bloody 181 

do. tbick 178, 181 

Extremities, cold 138, 150 

Eyes, brilliant 171 

Eyes, cornea of, cloudy , 175 

do. drawn to one side 216 

do. dull , 138, 200 

do. fixed and staring 226 

do. partial or complete blindness of. 322 

do. bloodshot 257 

do. feeling of sand in 174 

do. pupils contracted 171 

do. do. dilated 211 

do. sunken .' 256 

do. whites of inflamed 174, 181 

do. do. red 173 

do. do. yellowish 175, 309 

Eyebrows, pain over 354 

Eyelids, dropping of. ... > 219 

do. glued together after sleep 173 

do. heavy and depressed » 351 

do. pricking pain in 173 

do. swollen 174 

Eruption, around the waist 203 

do. between the fingers 298 

do. globular, on inflamed patches of skin 289 

do. yellow 205 

do with great itching 205 

do of round flat vesicles 288 



A GUIDE TO DIAGNOSIS. 775 

PAGES 

Eruption, of minute vesicles running together , . . . 290 

do. witli sour sweat 292 

do. of yellow clusters 293 

do. with burning itching 295 

do. followed by scales 296 

do. of small red patches on thighs and legs 302 

do. with smarting pain on face, and beard falls off 307 

Face, blueness of. 145, 155, 256, 369 

do. dingy red 139 

do. flushed.. 131,155,275,350 

do. pale ; 131,135 

do. puffiness of 371 

do. livid 370 

do. sallow and bloated 303 

do. small red points on 197 

do. shrunken 144 

do. swollen 197, 350 

do. twisted out of shape 226 

do. very red 171 

Fainting • , . . 232 

do. tendency to 319, 372 

Flatulence 194, 281 

Fear of danger to life 225 

Features, shrunken 185 

Feebleness 131 

Feet, cold 155, 350 

do. swelling of • • • • 283 

Fever 181, 186, 194, 328 

do. hectic 275 

do. typhus 197 

Fev^rishness 189 

Food, rising in the throat 318 

Forehead, dull pain in 350 

do. hot 350 

Frost-bites 361 

Fullness, after eating 220 

Gait, uncertain 322 

Gaping 144, 150 

Giddiness 131, 206, 216, 254 

Griping pains 194, 239, 271 

Gonorrhea 378 

Groin, swelling in glands of. 379 



776 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



PAGE8 



Crums, bleeding of. 302 

do. blueness of. 250 

Hands, clenched 226 

do. cold r 155 

do. picking of bedclothes 138, 156 

do. shrunken 144 

Head, cold in 180 

do. dull pain in, going down the back, 351 

do. feeling as if a cord bound around 351 

do. heat of. 139 

do. noise in '. 254 

do. pain in top of 193 

do. pain in 144, 150, 171, 198, 216 

do, small red points on 197 

do. swollen 197 

Headache, general 350 

do 131, 135, 155, 181, 200, 319 

do. from disease of brain 350 

do. rheumatic 193, 350 

do. sick 350 

do. nervous 350 

do. from fullness of blood-vessels 350 

do. with giddiness and flushed face 371 

Hearing, acute 131 

Heart, darting pain at 366 

do. palpitation of 194 

do. violent beating of 363, 370 

do. pulsates feebly 372 

do. weight, or oppression at 369 

Heartburn 220 

Heat of body, increased 130, 131 

Hiccup 138, 200 

Hoarseness 178, 200, 257 

Indigestion 193, 271 

Itch 298 

Itching, of body 304 

Jaws, locked 229 

do. lower swollen 199 

do. stiffness of. 178 

Joints, fissures of 291 

do. swollen and painful 191 

Knees, drawn up 186 



A GUIDE TO DIAGNOSIS. 777 



PAGES 



Kidneys, pains in region of , 283 

Languor 131, 135, 138, 154, 183, 220, 309 

Lassitude 319 

Legs, jerking, or starting , 138 

do. stiff. 302 

Lethargy , 211 

Limbs, aching of 155 

do. chilly 141, 150 

do. debility , 131 

Light, painful to eyes 171, 173 

Lips, blue 372 

do. do. nearly black 150, 155 

do. purple 286 

Liver, pain over 187, 309 

do. tightness over 187 

Loins, heat and heaviness in region of 330 

do. pain in 144, 196, 209, 255, 325 

Loss, of power to move 211, 216 

do. of sensibility 211, 216 

Memory, loss of 216 

Mind, cloudy 351 

Motion, aversion to 220 

Mouth, ash-colored spots in '. . 200 

do. bitter taste in 309 

do. blue 372 

do. clammy 350 

do. drawn to one side 216 

do. foaming at 211, 226, 235 

do. ropy mucus in 177 

do. dry in the morning 154 

Muttering 139 

Nails, blueness of 145 

Nausea 187, 198, 239, 310 

Neck, stiffness at back of 351 

Nervous depression 183, 200 

Nose, coldness of. 150 

do. bleeding of 206 

do. picking of 243 

Nostrils, fluids rejected through 200 

do. widened 178 

Numbness ., 216 

Oppression, sense of 131 



778 AMEHICAN HOUSEHOLD BOOK OF MEDICINE. 



PAGKS 

Pains, wandering , 135, 303 

do.' in loins, on one side, descending to the groin 328 

do. in right side over the liver -. . . 309 

do. in passing water 330 

do. in back. 200 

do. in loins 209 

do. twisting around the navel 242 

do. dull, in region of loins 330 

do. over the bladder 330 

do. at neck of bladder 343 

do. darting 346. 

do. dull, in forehead or temples 350 

do. over eyebrows 350 

do. constant, in head 352 

do. severe, in the face 354 

do. sharp, under left nipple 367 

do. do. do. do. extending to left armpit 367 

do on pressing, between ribs 367 

Palms of hands hot 350 

Palsy 216 

Palpitation, violent and irregular 367 

do. with strong upheaving 371 

do. frequent ; 372 

do. ordinary 233, 280, 283, 363 

Paralysis 216 

Penis, irritation of 322 

do. itching or pain at end of 330, 378 

do. blood from 378 

do. ulcer on end of , . 379 

do. yellowish discharge from 378 

Perinseum, deep-seated pain in 190 

Perspiration, cold , 183, 275 

do. of entire body 144 

do. . sour 191 

do. thick, and bad smelling 319 

Pricking feeling • 216 

Pimples, red 288 

Pulse, feeble 131, 150, 185 

do. feeble and irregular. 372 

do. frequent 131, 135, 138, 198, 275, 277 

do. fluttering '. 200 

do. full and round 191 



A GUIDE TO DIAGNOSIS. 779 

PAGES 

Pulse, full and hard 328 

do. irregular 286 

do. hard 131 

do. jarring 367 

do. quickened 131 

do. soft and weak 319 

do. small and rapid 178, 220, 255 

do. wiry 186 

Restlessness 198, 367, 370 

Eed points, on skin, after two days' fever 199 

Retching 350 

Rice-water discharges from bowels 256 

Sadness 225 

Saliva, increased flow of 354 

do. thick .350 

Scalds 356 

Scales, on hands and feet 299 

Sprains: * 356 

Straining, with no effect 321 

Swallowing, difficult 139, 177 

do. painful 178, 199 

Sea-sickness 251 

Sense of fullness 351 

Sleep, disturbed 138, 243 

do. dreamy 286 

do. must be in sitting posture 369 

Sweating 138 

do. cold 183 

Shivering 131, 135 

do. ushering in fever 325 

do. followed by pain under left nipple 367 

Skin, like that of a goose 131 

do. parched 131, 350 

do. hot and dry 135, 171, 178 

do. blotches on 139 

do. wrinkled , » « . , 139 

do. slightly bluish 144 

do. rough 144, 186, 199 

do. cold 183 

do. damp 185 

do. dry •. 271 

do. hot 275 



780 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



Skin, yellow '. 283 

do. dry and pale . , 283 

do. effusion of blood under 302 

do. blue and cold 372 

do. copper-colored eruptions on 380 

Side, pain, when lying on left ,».,.»... 187 

do. pain in 193 

Sighing 367 

Spirits depressed 187, 220, 328 

Spitting of blood 277 

Sight, acute 131 

Shoulder, pain in right 187 

Snoring 211 

Sobs 367 

Soreness, general , . . . . 155 

do. of muscles 144, 154 

Stomach, burning pain at pit of. ..«..,..«. 185 

do. gnawing at pit of 271 

do. weight at pit of. 207 

do. pain at pit of . .............. 139, 200, 314, 325 

do. sick 151, 171, 186, 198 

Sound, painful 171 

Stools, black 207 

do. bloody , 200 

do. hard, offensive, variously colored 194 

do. involuntary 138 

do. yellow 139 

do. unnatural in quantity and quality 242 

do. with " bearing down " 320 

do. straining 321 

do. sudden and frequent, but ineffectual calls to 375 

do. passage of, attended with smarting 376 

Stupor 139, 156 

Squinting ..,....,,,,. 219 

Suffocation, sense of 231 

do. do. on lying down 286 

Tears, flow of 173, 354 

Teeth, black matter about 156 

do. chattering. 144 

do. grinding of. 211, 243 

do. loose 303 

Thigh, numbness of 328 



A GUIDE TO DIAGNOSIS. 781 



PAGES 



Thirst 131, 135, 138, 154, 171, 186, 191, 198 

do. very great 256 

Throat, acrid sensation at back of 350 

do. sore 178 

do. ulcerated 139, 200, 380 

Toe, pain in great 194 

Tongue, brown fur on 200 

do. coated in back part and center 155 

do. coated thick 191 

do. dry 131, 135, 144, 171 

do. dry and white in the morning 220 

do furred 136, 144, 154, 319, 328 

do. loaded i 243 

do. " pointed " 156 

do. thick, yellow or brownish coat 197 

do. white 131, 135, 171, 271 

Tonsils, swollen 177,199 

Torpor 216 

Thumbs, turned in 226 

Ulceration in mouth 200 

Urethra, irritation of 322 

Urine, acid, smells strongly 330 

do. albumen 325 

do. bloody 187, 209, 325, 328 

do. coagulable 287, 326, 328 

do. clots of blood in 330 

do. constant desire to pass bloody 330 

do. difficult flow of 325, 380 

do. frequent .» 144,189,326 

do. frequent desire to pass ' 131, 272 

do. high-colored 138, 191, 328 

do. do. and scanty 283, 330 

do. large quantity of. 272, 322 

do. loaded 319 

do. painful discharge of 189, 381 

do. red 326 

do. red deposit in 131, 220 

do. scanty 131, 138, 155, 303, 325 

do. stoppage of 151, 257, 323, 324 

do. white sediment in 145, 155 

Veins, swollen 350 

do. do. and inflamed 373 



782 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



Voice, feeble 139 

do. hoarse 200 

Vomiting 131, 151, 156, 171, 185, 186, 187, 189, 200, 255, 350 

do. bilious 171 

do. of blood 207 

do. of onion-smelling matter 249 

do. sour 220 

Warts 301 

Watchfulness 171 

Water, dread of. ' 235 

do. frequent desire to pass 272 

Weakness, extreme 138, 150 

do. muscular 131 

Wheezing 233 

Windpipe, pain at top of ^ 178 

Wrists, starting of 138 

Worms, passed from bowels 243 

Yawning 144, 150 



Diseases of Women. 



After-pains 458 

Ankle, swelling of .......................... , 404 

Appetite, depraved .- 399 

do. loss of, after delivery 465 

Arteries, throbbing of 399 

Abdomen, acute constant pain low down in, third or fourth day 

after delivery 463 

do. deep-seated pain in, after delivery 464 

do. do. do. do. relieved hy pressure. 465 

do. distended with wind 419 

do. dropsical 420 

do. drum-like, with fever and deliriums after delivery. .. 464 

do. irritability of, with frequent desire to make water 417 

do. sudden, sharp pain in 420 

do. tightness and pain across. 417 

Backbone, pain in, with weak legs 422 

Breast, hard, round, movable, swelling in 383 

do. violent, darting pains in 383 

do. excessive flow of milk from 455 



A GUIDE TO DIAGNOSIS. 783 



PAGES 



Breast, hard, swollen, and painful, third day after delivery 456 

do. flaccid, after delivery 466 

do. knotty, lumpy, and painful 456 

do. pain under left, with tightness of chest, and difficulty of 

breathing 41? 

do painful, tender, enlarged 421 

Bearing down 388, 409, 417 

Breathing, hurried 400 

Blood, coughing of 422 

do. vomiting of 422 

Bowels, offensive discharges from, after delivery 4G5 

Cancer, of breast , 383 

Cramps, in pregnancy 449 

Chest, oppression of, with difficulty of breathing, palpitation, and 

speechlessness 41 9 

Chills, followed by flushes, after delivery 465 

Courses, painful 406 

do. with clots, and violent bearing down 407 

do. with flushes, chills, and headache 407 

Cough, hysterical 421 

do. spasmodic I 417 

Coughing of blood 422 

Croup, imitated . 421 

Constipation, with retention of urine ...., • 417 

Costiveness, in pregnancy 435 

Depression, during pregnancy 451 

Ears, ringing in 403 

Exhaustion, with aching across hips 403 

Eyes, black circle around 400 

do. dark circle under 395 

Eyebrows, pain over , 421 

Eyelids, trembling of 422 

Faintness, during pregnancy, with pains coming and going about 

hips and loins 451 

Flatulence 399 

Feet, swollen, pitting on pressure 400 

Giddiness, with headache 403 

Hair, falling off of 400 

Headache, during pregnancy . . , 450 

Head, throbbing pain in, after delivery 466 

Hiccup .^ 421 

Hips, aching across 403 



784 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

PAGES 

Languor 395 

Laughter, hysterical 419 

Legs, numbness, cramps or palsy of 417 

Light, painful to eyes, in lately-delivered women 466 

Loins, aching across 403 

do. constant pain in 432 

do. weakness in , 395 

Longings in pregnancy 434 

Menstruation, painful 406 

do. with flushes, chills, and headache 407 

do. with clots, and bearing down 407 

Milk, checked, or entirely stopped, a few days after delivery. 464, 466 

Mind, depressed 400 

Morning sickness 441 

Nipple, bleeding from 384 

do. drawn in. . » 384 

do. little tubercles around 384 

Pain, with bearing down, when making water 388 

Pains, in the back 388 

do. in the back and loins 392 

do. at lowest point of backbone 394 

do. at lower part of backbone, with dragging in the hips and 

thighs 394 

do. in the side 400 

do. in left side 403 

do. constant, around brim of hip-bones 432 

do. going and coming, about hips and loins in pregnancy. . . . 451 

Periods, commencement of. 396 

do. discharge of thick matter, before or after 395 

do. disturbed and painful, with irritability of spine 417 

do. do not appear at proper time 402 

do. excessive flow of, with clots 402 

do. great pain of. 406 

do. sudden stoppage of 401 

Pulse, frequent and small 400 

do. frequent, full, and hard after delivery 466 

do. quick, with hot skin and furred tongue 420 

Restlessness and sleeplessness after delivery 464 

Staring about 418 

Swallow, seeming inability to 421 

Spine, curvature of 413 

Spinal irritation 417 



A GUIDE TO DIAGNOSIS. 785 



Sitting up erect from necessity 417 

Skin, hot, with quick pulse, and furred tongue 420, 464 

Side, pains in left 421 

do. pain in, during pregnancy 450 

Shivering, severe, third or fourth day after delivery 463* 

do. slight, with tongue slightly coated 465 

Sound, annoying to lately-delivered women 466 

Stomach, sour 399 

Stools, dark, slimy, or watery after delivery 465 

Sudden spasmodic attacks 418 

Throat, a feeling as of a ball rising in 418 

do. stiffness of , 418 

Urine, frequent desire to pass 388 

do. do. do. do. with difficulty in passing 430 

Vagina, feeling as of some foreign body in 388, 409 

do. fetid, variously-colored discharge from ; 386, 409 

do. heat and soreness of 392 

do. itching, externally 392 

do. thick, white 'discharge from 394 

do. weight and uneasiness in, with frequent desire to make 

water 409 

do. watery discharge from, without smell 411 

do. whitish discharge from 388 

Voice, total I'oss of 421 

Vomiting, occasional, a few days after delivery 464 

do. hiccup, and diarrhea, after delivery 464 

Weeping, hysterical .' 419 

Whites 391 

Womb, darting pains in 386 

do. falling of. 388 

do. neck of, feels hot, swollen and painful 430 

do. pain on external region of, increased by pressure 430 

do. weight and bearing down of. 430 



Diseases of Children. 



Appetite, bad or variable 499 

do. depraved 492 

do. greedy 501 

50 



786 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



Abdomen, enlarged and hardened glands in middle of, causing 

pain on pressure 495 

do. swollen 518 

do. sunken 518 

Belly, bladders formed on , 546 

Belly, dull pain in , 501 

do. hotter than rest of body 501 

Breasts, swelled, in infants , 548 

Breath, bad, offensive r 245 

Breathing, interrupted and sighing 503 

do. laborious, and convulsive 513 

do. loud, difficult, labored ^ 526 

Body, hot, with cold limbs .* 518 

do. thinning of. 245 

Bowels, confined and shrunken 500 

do. green discharges from 515 

do. large do. do. . ♦ 501 

do. loose during teething 481 

do. looseness of ; . . 517 

do. light-colored discharges from 518 

do. irregular 492 

do. protruding 524 

do. scanty, mud-colored discharges from 499 

do. slimy discharges from -, 245 

Chest, becomes narrow, and breastbone projects forward 492 

Cheeks, pale and cool 503 

do. ulcers on inside of. 509 

Children, still-born 542 

Chills and heat 529 

Chin, swelling of glands under 512 

Convulsions, during teething 481 

Cough, croupy 513, 529 

do. rough, with hoarseness 526 

Coughing, in paroxysms, with difficult breathing and whooping . . 549 

Cough, sounding as from a trumpet 526 

Croup 526 

Crowing sound when drawing breath 527 

Cry, short and sharp 499 

Delirium 518, 529 



do. at night 499 

Dreams, unpleasant , 245 

Digestion, impaired 492 



A GUIDE TO DIAGNOSIS. 787 



PASES 



Dizziness, heaviness, giddiness, and headache 498 

Drowsiness, restless 499 

Ears, bad smelling discharge from 483 

do. eruption behind 483 

do. inflamed membrane of -483 

Emaciation, with soft, flabby flesh 518 

Eyes, half-shut, regardless 503 

do. kept closed 499 

do. livid, protruding , 527 

do. loss of power to direct to any object 467 

do. opened and closed, with expression of languor 502 

do. suff"used and watery 529 

do. thrown upward 467 

do. yellowness of whites in, in infants . . . -^ 547 

do. whites of, red in infants a few days old 547 

Eyebrows, knit, to shut out light 499 

Eyelids, swollen, in infants a few days old 547 

Face, dark, copper-color of 545 

do. feverish 529 

do. flushed, dry skin and hot head 499 

do. round red dots on 529 

do. shows anxiety and sufi"ering 499 

do. swollen and purple 527 

Features, pale and shrunken 517 

Feet, swollen, dry, hard, and cold 546 

do. cold 515 

Fever 245 

do. remitting 518 

Flesh, loss of, notwithstanding vigorous suckling 515 

do. soft and flabby 492 

Food, no desire for, only for drinks 515 

Forehead, round red dots on 529 

do. tilted forward 507 

Giddiness 245 

Griping, flatulence and diarrhea 515, 523 

Hair, falling ofi" in patches 538 

Hands, cold 515 

Head, enlarged 492 

do. enlarging of 507 

do. heaviness of, with drowsiness 502 

do. hot, with dry skin and flushed face 499 

do. long, broad, and deep, but flattened at the top 507 



788 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 

PAGSS 

Head, roHing of on the piUow , 522 

do. soft spot of, full and prominent 503 

do. do. do. sunken in 503 

Heat and cliills 529 

Hoarseness, witli rough cough 526 

Languid and feverish 492 

Languor, shivering, hot skin and thirst 529 

Legs, weak and bending 492 

do. one stretched out, the other drawn up 500 

do. drawing up of, with crying atid local pain 467 

Light, painful 547 

Lips, blue ; also cheeks and nails blue 544 

do. swollen and surrounded with eruption 509 

Mouth, clusters of whitt spots in 510 

do. dribbling of saliva from 509 

do. foaming at 545 

do. heat, and redness of the lining of 509 

do. ulcers on roof of 509 

Navel, dark red shining spots on or near 545 

Neck, scrofulous abscess in 483 

do. swelling of glands of 483 

Nose, picking of 245 

Nostrils, moist 501 

Palate, swelling of. 512 

Peevishness and fretfulness 514, 51 5 

Perspiration, after eating or drinking, with signs of fever 501 

Pimples, red, on face, neck, and hands of infants a few days old. 548 

Prostration, with cold clammy skin 517 

do. with formation of thick, white, false membrane in 

throat , 512 

Pulse, quick 529 

Purging of green matter 515 

Restlessness and difficulty of breathing 546 

Scalp, eruption on 483 

Swallowing, difficult 510 

do. difficult, with returning of liquids through nostrils. 512 

Sleep, starting from 245, 467, 499 

Sleeping with eyes partly open 499 

Sneezing and running from nose 527, 529 

Skin, blue patches scattered over , 518 

do. clammy 518 

do. cold 503 



A GUIDE TO DIAGNOSIS. 789 



PAGES 



Sldn, dry and hot 517 

do. dry and rough 492 

do. yellowness of, in infants 547 

Spine, round tumor on lower part of, when born ^43 

Stomach, rejects every thing 517 

do. tenderness of . . o 522 

Stools, dark brown, or black and offensive 524 

do. feculent and liquid 523 

do. green 515, 524 

do. large 501 

do. mixed with mucus 523 

do. offensive and slimy 546 

do. white 496 

Stupor 500 

do. following rolling of the head on pillow 522 

Suck, refusal to 546 

Suffocation, from formation of false membranes in throat 513 

Teeth, grinding of, during sleep 499 

Teething, convulsions during 481 

do. fever during 481 

do. gums red, swollen, and hot 481 

do. looseness of bowels during 481 

Thirst, great 499, 515, 523 

Twitching of angles of mouth .' 502 

do. of face and limbs 502 

Throat, brown spots in, surrounded by purple skin, with bad smell. 511 

do. cluster of white spots in olO 

do. patches of false membrane in back part of. 512 

Tongue, red at tip and edges, white fur on center 499 

do. ulcers on 509 

do. with ulcerated edges 518 

do. white or yellow 523 

Thumbs, drawn into the palms of the hands 502 

Ulcers on inside of cheek 509 

do. on roof of mouth 509 

do. on tongue 509 

Urine, much colorless, discharged 501 

do. scanty 529 

Vagina, scrofulous discharge from 484 

Voice, hoarse and indistinct 513 

do. tone of, alters 510 

Vomiting, accompanied by purging 517 



790 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



PAGES 



Vomiting, and retching 515 

do. of greenish phlegm 499 

do. of curdled milk 515 

Wakefulness, with rolling of head on pillow 522 

Walk, slow 501 

Wasting away of body, regular and slow 494 

Wheezing and labored breathing 527 

Whooping-cough. , 548 

Yellowness of skin and whites of eyes in infants a few days old. 547 



Cases of Poisoning. 



Agitation, nervous 566 

Abdomen, drum-like and painful 558 

Apoplexy 563 

Back, stiffness of. 565 

Belly, tenderness of 555 

Belching, coppery 559 

do. with vomiting and hiccup 558 

Breathing, by spasms or fits , 565 

do. very heavy and labored 560 

do. difficult 555, 557, 558 

Body, red, puffy blotches on 568 

Bowels, bleeding from 557 

do. pain in, like " colic " 555 

do. signs of inflammation in 556, 561 

Cramps and convulsions 555, 557 

do. do. frequent 557 

Chills 568 

Coldness of skin and extremities 558 

Colic 561 

do. and purging. . . . , 559 

Convulsions 558 

do. alternating with fainting 561 

Deafness, with headache 551 

Delirium 558 

do. of a merry, laughing character 566 

do. followed by dozing, with deep snoring 566 

Drowsiness 565 

Eyes, pupils of contracted 563 



J 



A GUIDE TO DIAGNOSIS. 791 

PAGES 

Excitement, violent 566 

Face, redness and swelling of 568 

Faintness 560 

Fainting, with griping of stomach 557 

Griping of stomach 557,^558 

Headache, with deafness 561 

Head, drawn back, with stiff back 565 

do. pains in 568 

Heartburn and hiccup 557 

Hoarseness of voice ,,..,.,..,, 558 

Jaundice, appearance of 558 

Jaws, locked 566 

Insensibility, sudden, with falling down of person affected 572 

Mind, confused 573 

Mouth, bleeding from 557 

do. dryness of, with intense thirst 558, 560 

do. dry and hot, with bitter taste 562 

do. metallic taste in 557, 558 

do. sharp, sour, burning taste in 555 

do. Urinous taste in 556 

Nausea and fainting ...,., 558 

do. with efforts to vomit 559 

do. with headache and vomiting 573 

Nose, bleeding from 557 

Palsy 558 

do. of limbs 561 

Pulse, sinking 566 

Purging of dark bloody matter 556 

do. of green, watery matter 558 

do. with pains in belly , 566 

Retching and vomiting 566 

Swallowing, burning difficulty of ,.„.., ^ 556 

do. difficult 558 

do. do. and painful 558 

do. do. with strangling sensation 562 

Sleepiness, followed by stupor, palsy, and apoplexy 563 

Sweats, cold, clammy 555, 559, 560 

Skin, itching of 568 

Sight, dim 565 

Stomach, burning pain in 555, 558 

do. sharp pain at pit of 556, 557 

do. signs of inflammation of 561 



792 AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



Stomacli, great pain at pit of 561 

Stools, bloody 558 

do. frequent, with blood 555 

do. green, watery, and " bearing down " 558 

Stupor 563, 565 

do. sudden , 564 

Taste, bitter 562 

do. coppery 559 

do. metallic, with tightness of throat 560, 562 

do. nasty metallic 558, 560 

Thirst, great 555 

Throat, burning in 555 

do. strangling in 562 

do. tightness of, with metallic taste in mouth 560 

Tongue, dry and parched 559 

Tottering, as if intoxicated 562 

Urine, difficulty and pain, with some blood in passing 561 

do. painful and frequent attempts to pass 555 

Vomiting of bitter stuff, with blood 555 

do. of bloody matter, with quick pulse 561 

do. do. do. with sinking pulse 560 

do. with belching and hiccup 558, 560 

do. of matter mixed with blood 556 

do. of greenish-yellow matter mixed with blood, after much 

retching 558 

do. severe 557 

Voice, hoarse 558 

Weakness and sinking 562 



TABLES OF DOSES, WEIGHTS, AND MEASURES. 



APOTHECARIES WEIGHTS. 

20 grains make one scruple, marked 9j. 

3 scruples do. drachm, do 5j, 

8 drachms do. ounce, do ^j. 

12 ounces do. pound, do ibj. 



LIQUID MEASURES. 
60 drops, or 60 minims make one draclim, marked.. . . ^j. 

8 drachms do. ounce, do ^j. 

20 ounces do. pint, do Oj. 

8 pints do. gallon, do Cong. 

For the information of those who may not have at hand the meas- 
ures used by druggists, the following table is prepared : 

LIQUIDS. 

A tea-spoonful of liquid equals 60 drops, or one drachm. 

K tahle-spoonfid do. do. -J ounce, or four dracJuns. 

A dessert-spoonful do. do. 180 drops, or three drachms. 

A icine-glassful do. do. 1\ ounces. 

A tea-spoonful of light powder, such as magnesia, equals ten to 
twenty grains ; of a heavy one, as sulphur, thirty to forty grains ; of 
a metallic oxide, sixty to eighty grains. 



DOSES OF MEDICINES. 

These must be graduated according to the age. Suppose the dose 
for a grown-up person to be 12 grains, then for a child under 



1 year, 


the d( 


3se w] 


Lll be 


s one-tweiith, or 1 


gram. 


2 do. 


do. 




do. 


one-eighth, or 1^ 


o-rams. 


3 do. 


do. 




do. 


one-sixth, or 2 


do. 


4 do. 


do. 




do. 


one-fourth, or 3 


do. 


7 do. 


do. 




do. 


one-third, or 4 


do. 


1-4 do. 


do. 




do. 


one-half, or 6 


do. 


20 do. 


do. 




do. 


two -thirds, or 8 


do. 


21 to 60 


years 


the dose will be 12 


do. 


e the age 


of 60 


years 


, the dose diminishes as the age increases. 












(793) 



INDEX. 



PAGES 

Abdomen or pendulous belly 69 

Abercrombie on dyspepsia 222 

Abscess, milk 456 

Abscesses in children 546 

Absorbents 34 

Acetate of lead 278 

Accidents 670 

Acid, carbonic, fevers from 572 

do. gallic 210 

do. nitro-muriatic bath 48, 583 

Acids in urine 331 

do. poisoning by 555 

Acid for ringworm 541 

do. nitric, poison 555 

do. hydrochloric, poison 555 

Acidulous waters 121 

Acne or copper nose 306 

Accouchement, directions after 459 

Aconite, poison 562 

Acrid plants, poisonous 562 

Advice to emigrants 606 

After pains 458 

Agents, noxious to life 17 

Ague 145 

do. an endemic 24 

Air, atmospheric, its composition 

and state 18 

do. quantity necessary in respira- 
tion 19 

do. heated and vitiated, a cause 

of disease 19 

do. cold streams of, to be avoided. 20 

do. as to humidity 21 

do. Budden variations of, danger- 
ous 21 

do. causes of vitiations of 28 



PAGES 

Air-pipe, foreign substances in 576 

Alarming convulsions, signs of..... 498 

Albumen, in nutrition 64 

do. in urine 332 

Alcohol, poison 566 

Alcoholic drinks 75, 79, 81 

Ales 75 

Alkalies, poisoning by 556 

Alkaline waters 121 

Almond emulsion 90 

Aloes and quinine 316 

Alum draughts 278 

Alteratives 602 

Amenorrhoea 399 

Ammonia, poisoning by 556 

Amaurosis 322 

Anasarca, or dropsy 283 

Aneurism 373 

Angina membranace8e..(diptheria.) 512 

do. pectoris 231 

Animals 708 

Animal diet 736 

Animal life, how supported 63 

Animal matter, ultimate elements. 19 
Animal matter tissues require ni- 
trogen , 63 

Animate beings 708 

Animation, suspended from char- 
coal vapors ...... 571 

Animation suspended , 676 

do. do. from strang- 
ling 576 

Anodynes 603 

Antacid Medicines .. 691 

Potash 
Soda 

(795) 



796 



AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



Antacid Medicines.. 
Ammonia 
Sal volatile 
Chalk 
Magnesia 



PAGES 

... 691 



Antimony, as poison 557 

Anti-putfescent gargle 202 

Antispasmodic Medicines 604 

Ammonia 

Assafetida 

Galbanum 

Sagapenum 

Valerian 

Camphor 

Cajeput oil 

Anus, prolapse of, in children 524 

Aperient Medicines 592 

Manna 

Scammony 

Charcoal 

Magnesia 

Sulphur 

Castor-oil 

Tamarinds 

Dandelion 

Cream of tartar 

Croton oil 

Rhubarb 

Jalap 

Aloes 

Calomel 

Colocynth 

Aperient pills 132 

do. mixture 132 

Aphthse 509 

Apoplexy 211 

Apple-tea 89 

Apples and rice, or snow-balls 93 

Aquafortis, poison 655 

Ardent spirits 79 

Ardent spirits, as poisonous 666 

Arnott's valve 23 

Arrack 80 

Arrowroot pudding 92 

do. blancmange 93 

do. mucilage, with milk or 

beef 93 

Arsenic 668 



PAGES 

Arteries 718 

Arterial blood, its use 18 

Artificial goat's milk 91 

do. asses' milk 92 

Asiatic cholera 253 

Assafetida clyster 238 

Asthma 233 

Astringent Medicines 604 

Catechu 

Kino 

Logwood 

Oak bark 

Galls 

Lime-water 

Whortleberry 

Bistort 

Pomegranate 

Tormentil 

Buchu 

Pareira 

Rhatany 

Linseed 

Liverwort 

Sarsaparilla 

Sulphuric acid 

Alum 

Sulphate of iron 

Sulphate of copper 

Zinc 

Sugar of lead 
Atmosphere, electrical variations 

of. 24 

Atonic ulcer...... 288 

Atrophy 494 

Azote 709 

B 

Bacon, rancid, poison 567 

Bad breast 456 

Bakers' itch 297 

Balance step 679 

Baldness 308 

Bandage, in hydropathy 60 

Barbers' itch 307 

Barbadoes, nut 662 

Barettier 29 

Barley wine 96 

Barley water 90 

Barrenness 428 



INDEX. 



797 



PAGES 

Baryta as a poison 661 

Bath, the cold, tepid, warm 44, 45 

do. in what diseases useful 45 

do. the hot,..., 46 

do. the vapor 46 

do. the hip 47 

do. the shower 47 

do. the foot 48 

do. for liver diseases..^ 48 

do. ofiodine 489 

do. hot douche 489 

do. air-pump vapor 49 

do. the shower 49 

do. remarkson 50 

do. hydropathic 55, 56 

Bathing, rules for 50 

Bathing during pregnancy 437 

Baths, their temperature 44 

Batter pudding 94 

Baume de vie 595 

Beaumont's experiments 753 

Bedrooms and beds 31 

Beef-tea 88 

Beer 75 

Belladona against scarlet fever.... 202 

Belly, drum 281 

do. dropsy of 285 

Benzoin ointment and lotion 455 

Bile 37 

do. its uses 37 

do. but little in the motions 38 

do. quantity of, poured into the 

bowels 38 

Bilious disorders 38 

do. do. prevention and 

treatment of 39 

do. evacuations, what are, and 

whatare not 311 

do. disorders in hot climates... 312 

Bilious fevers 142 

Birth of beings 707 

Bittersweet, poison 663 

Bladder, inflammation of. 189 

do. falling down of. 387 

do. during pregnancy 449 

Blanc-mange, arrowroot 93 

Bleeding from nostrils 206 

Blisters, immediate or instantane- 
ous 586 



PAGES 

Blisters, by lunar caustic. 686 

do. danger from, in children, 

and when 587 

Blisters with nitric acid 253 

Blood, vomiting of. 207 

do. spitting of. 277 

do. from kidneys 209 

do. from bowels 208 

Blue disease 372, 544 

do. pill 140 

do. line on gums a sign of lead 

poison 250 

do. stone, poison 559 

do. vitriol, do 559 

Body, natural heat of 20 

Boiling 65 

Bowels, looseness of. 271 

do. lower stricture of 321, 

do. looseness of during preg- 
nancy 445 

Brain, inflammation of. 171 

do. diseases in children 498 

do. overworked 28 

Branchias 718 

Brandy 80 

Bread, panada 88 

Bread pudding 93 

Bread, the "staff of life" 737 

Breakfast, proper time for 67 

Breast, cancerof 383 

do. sore 438 

do. distended 449 

do. shields for .' 455 

do. bad, or milk abscess 456 

do. pang 231 

Breasts, during pregnancy 438 

Breathing 19 

Bright's disease 325 

Broiling and baking 66 

Broken bones 579 

Bronchitis, or inflammation of bron- 
chi 181 

Bronchocele 349 

Broths 95 

Bruises, or contusions 578 

Bryce's test 534 

Bryony, poison 562 

Bulimia 317 

Bunions 300 



798 



AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



PAGES 

Burns and scalds 356, 577 

do. contractions after 360 

Buttercup, poison.... 662 

Buttermilk 92 

C 

Calculus in urine 341 

Calomel, poison...... 658 

Camphor, poison 664 

Cancer, or scirrhus 345 

do. operation for 387 

do. ofbreast 383 

do. of womb 383 

Canker in mouth 614 

Canine madness 235 

do. appetite 317 

Cantharides as poison 561 

Carbonic acid as poison 671 

Carbon in breathing 18 

do. quantity of, in fibrine...... 19 

do. a deadly poison, when 19 

do. less got rid of, in hot cli- 
mates and in hot weather 

than in cold 40 

Carditis 367 

Carus 211 

Caseine 63 

Castor-oil cakes 479 

do. emulsion 472 

Cataplasm, charcoal 171 

do. chlorinated soda 171 

Catarrh 179 

Cathartics 693 

Cauliflower excrescence of the 

womb 411 

Caustic, blister 586 

Caustic soda, poison 556 

Celandine, poison... 562 

Cellular membrane 710 

Cellular tissue, induration of, 546 

Chalk, mixture against diarrhea... 591 

Chalybeate waters 122 

Champagne wine 78 

Cherry laurel, poison 563 

Chest, dropsy of. 286 

Chewing and swallowing 744 

Chicken broth 95 

do. panada ,. 95 

Chickenpox 288 



PAGES 

Chicken-breasted children 32 

Chicken tea 89 

Chilblains, lotion for 362 

Child-bed fever.. 464 

Childhood, treatment of 486 

do. convulsions in 498 

Children, diseases of. 467 

do. doses of medicine for 469 

do. medicines for 469-^79 

do. mortality of. 22 

do. still-born 542 

Chills and cold feet, pernicious 43 

Cholera 262 

do. Asiatic 263 

do. infantum 517 

do. how produced 25 

Chloride of soda injection 387 

Chlorosis 399 

Chronic pericarditis 369 

do. inflammation of womb 431 

Chyle, receptacle of 35 

Chylification ., 760 

Chymification 750 

Circulating system 709 

Citrate of iron 395 

Clap 378 

Climbing 701 

Climate, hot, influence over liver... 311 

Climatology of United States 97 

Clothing 43 

do. during pregnancy 436 

Clyster of assafetida 424 

Coal gas as a poison 673 

Cold water, to drink 50 

do. intense 576 

do. common 179 

Cold and chilblains 361 

Colic 237 

do. from worms 241 

do. painters' 249 

Colon, stricture of. 321 

Coma. 211 

Combustion, spontaneous 83 

Comedones 305 

Consumption 275 

Contusions 578 

Convulsions, signs of....' 501 

Cookery 64 

do. for the sick 85 



INDEX. 



799 



PAGES 

Copper as a poison 559 

do. nose 306 

Cordial medicines 596 

Corpulency 279 

Corns 300 

Corroding ulcer in womb 412 

Corrosive sublimate, poison 558 

Courses, stoppage of. 401 

Costiveness 318 

do. drops for 320 

do. during pregnancy 435 

Cow-pox 532 

do. and small-pox, identity of. 536 

Cramp 229 

do. linimentfor 253 

do. in pregnancy 449 

Credulity of the public 51 

Cretinism 350 

Croton oil, externally 585 

Croup, true and spurious 526 

Crown imperial, poison 562 

Curvature of spine 413 

Cuts and wounds 579 

Cystites 189 

D 

Daffodil, poison 662 

Dandelion, for the liver 189 

Dandriff 297 

Deadly nightshade, poison 564 

Deaf and dumb 317 

Decline, mesenteric 494 

Decoctions 605 

Deformities 543 

Delirium tremens 607 

Delivery, inflammation after 463 

Detector-acid 541 

Diabetes 271 

Diaphoretics 601 

Diarrhea 271 

do. ofinfants 523 

do. during pregnancy 445 

Diet and food 62 

Difficult menstruation 406 

Difficulty in voiding urine.. 323 

Dilatation of the heart 372 

Diluents 600 

Dinner 68 

do. pills 321 



PAGES 

Diminution of mortality 23 

Diphtheria 512 

Discharges, female 396 

Disease, general causes 130 

do. of kidneys 325 

do. venereal 379 

do. prevention of. 17 

Diseases of pregnancy 442 

do. of children 467 

do. oftheskin 288 

do. of the heart 363 

do. of women 388 

Disinfectant, heat ; 203 

Disinfecting, clothes 208 

Dislocations 581 

Diuretics 600 

do. in dropsy 284 

Doses of medicine, as to age 793 

Douche bath in hydropathy 56 

do. in hysteria 424 

Drake's, Dr., prescription for ague 

and fever 148 

do. prescription for remit- 
ting fever 158 

Draughts, effervescing 133 

Dress, protection by 48 

Drops, for pain during pregnancy. 408 

do. for inflamed eyes 583 

do. for costiveness 320 

Dropsy 282 

Dropsy of belly.. 285 

do. of kidneys 287 

do. of cellular membrane 283 

do. of chest 286 

Drowning 574 

Drum belly 281 

Dry pimples 294 

Dry tetter 297 

Drying-up of milk 462 

Dysentery 194 

Dysmenorrhoea 406 

Dyspepsia 220 

Dysury 323 

E 

Ear, scrofulous 492 

Ears, substances in 577 

Eating, times of 67 

Eczema... 290 



800 



AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



PAGES 

Eczema, clironic 291 

Ecthyma 294 

Effects of wet-sheet packing 58 

Effervescing draughts 133 

Education of children 28 

Elder, poison 562 

Electricity and cause of pain 353 

Electuary for piles 208 

Embrocations for hair 309 

do. (baldness) 309 

do. of tartar emetic 418 

Emetics 696 

Ipecacuanha 

Tartar emetic 

Sulphate of copper 

Sulphate of- zinc 
Emigrants, advice, directions and 

cautions to 606 

Emphysema 280 

Emulsion, almond 90 

Enamel as a poison 562 

Encephalitis 171 

Endemics and epidemics 24 

Enlarged veins in pregnancy 448 

do. glands 49i 

do. do. mesenteric 494 

do. heart 371 

Enlargment of prostate gland 381 

Enteritis 186 

Enuresis 322 

Epilepsy 226 

Epistaxis, or bleeding at nose...... 206 

Erysipelas 195 

do. of infants 645 

Ergot, poison 564 

Eruptions, miliary 292 

Eruptive fevers 195 

Eruption, vesicular 205 

Excision of cancerous disease 387 

Excrescence of womb, cauliflower.. 411 

Excretion 62 

Exercise, during pregnancy 436 

Exercise, essentially necessary 32 

do. uses and effects of. 33 

do. proper times for 33 

Expectoration in consumption 275 

Extension motions 6"69 

Eye, inflammation of 172 

Eyelids, ointment for 584 



PAGES 

Eye lotions, washes, and drops 583 

Eyes, foreign substances in 577 

F 

Face-ache, or tic douleureux 65S 

Fainting 232 

do. fits, in pregnancy 446 

do. do. treatment of 582 

Falling down of bladder 387 

False measles 288 

Falling down of womb 388 

Fat, how formed 40 

do. uses of 42 

do. proportion of. 736 

Felon 622 

Fevers 130 

do. prevented by ventilation... 672 

Fever, inflammatory 131 

do. mixed 135 

do. typhus 138 

do. intermittent, or ague 143 

do. milk 466 

do. remittent 154 

do. yellow 162 

do. eruptive 195 

do. scarlet 198 

do. hectic 275 

do. puerperal, after delivery,... 464 

do. drinks in 133 

do, drunkard's 607 

do. spotted 138 

do. putrid 138 

do. maculated " 138 

do. bilious 142 

do, rheumatic... 191 

Fibrine, animal and vegetable 64 

Fields for emigration 606 

Fish, diseased, poison 567 

Fish-skin 299 

Fistula in ano 378 

Fits, nine-day 545 

Flatulence 224 

do. drops for 239 

Flesh, of human body, incombusti- 
ble 83 

Flow of milk, excessive 455 

Fluids of the body 706 

Flummery 93 

Fluor albus 391 



INDEX. 



801 



PAGES 

Food, cookery of 64 

do. too much, dangerous 69 

do. nitrogenous and non-nitro- 
genous 63 

do. animal and vegetable, digest- 
ibility 71 

do. nutritious for a cMld 488 

do. and digestive process 724 

do. quantity required 738 

Fool's parsley, poison 665 

Foreign substances in eyes and 

ears 577 

do. substances in air-pipe 576 

Fowl with rice 96 

Foxglove, poison 565 

Fractures 579 

French wines 76 

Friction, spinal, etc 56 

Frostbites 361 

Frying 66 

G 

Gallstones 313 

Gallic acid 210 

Galvanic circle in the human body. 354 

Gangrene 170 

Gargle for sore mouths 172 

Gas, carbonic acid 571 

do. coal, or carbureted hydrogen. 573 

do. from drains and sewers 573 

Gastric juice, Beaumont's experi- 
ments with 751 

Gastritis 185 

Generation 707 

Germs 707 

Giddiness 233 

Gin 80 

Gingerbread of jalap 474 

Gland, prostate 381 

do. enlarged 381 

do. mesenteric 35 

Glands in neck enlarged 491 

do. scrofulous 483 

Glass, swallowed 562 

Glossitis 176 

Goosegrass 290 

Gonorrhea 578 

Gonorrheal ophthalmia 176 

Goulard's extract, poison 562 

51 



PAGES 

Gout 193 

Gouty headache 362 

Granular disease of kidney 326 

Gravel 330 

do. of cystic acid 332 

Gravy, rice ."* 95 

Gray powder 603 

Green scour 515 

do. sickness 399 

Gregory's powder 591 

Ground rice milk 88 

Grubs 305 

Gruel 87 

Guinea worm 248 

Gum, yellow 547 

do. red 548 

Gums, blue line on 250 

Gymnastics 654 

H 

Haemoptysis, or spitting of blood... 277 

Hair, deficiency of. 308 

do. applications to promote the 

growth of 309 

do. to remove superfluous 309 

Harelip 643 

Hartshorn jelly 88 

Hartshorn, poison 556 

Head, water in the 507 

do. do. do. distinguished 

from worm fever 501 

do. water in the, spurious 602 

Headache, various kinds of. 350 

do. from affection of brain. 352 

do. from fullness 351 

do. gouty 352 

do. during pregnancy 450 

Health, index of. 34 

Heart, diseases of. 363 

do. palpitation of 363 

do. neuralgia of. 366 

do. inflamed bag of. 367 

do. water in bag of 369 

do. inflammation of 370 

do. disease of valves of...... 370 

do. enlargement of. 371 

do. dilatation of. 372 

do. atrophy of. 372 

Heartburn in pregnancy 444 



802 



AMEKICAN HOUSEHOLD BOOK OF MEDICINE. 



PAGES 

Hectic fever 275 

Heat, as a disinfectant in plague 

and fevers 203 

Hedge hyssop, poison 562 

Hellebore, poison 562 

Hemiplegia 216 

Hemlock 564 

Henbane, poison 563 

Hepatitis , 188 

Herbivorous animals 735 

Hernia 582 

Herpes 289 

Hiccup 231 

Homeopathy 54 

Hot climates 312 

How to nurse the sick 627 

Human ruminants 318 

Humid scall, or eczema 290 

Hunger 724 

Hydrocephalus 507 

Hydrochloric acid, poison 555 

Hydrogen 573 

Hydropathy 54 

Hydrophobia 235 

Hypochondriasis 225 

Hypertrophy 371 

Hysteria 418 

Hysterics, 418 

I 

Ichneumon 241 

Ichthyosis 299 

Icterus 309 

Iliac passion 239 

Imagination and fancy, too much 

fostered 30 

Immoderate flow of urine 322 

Immediate or instantaneous blis- 
ters 586 

Impetigo 293 

Inanimate beings 708 

Incontinence 322 

Indian club exercise 671 

Indigestion 220 

do. of infants^ 514 

do. during weaning 515 

Induration of cellular tissue 546 

Infantile indigestion 515 

Infants' swelled breasts 548 



PAGES 

Infants, apparent death in new- 
born 577 

Infants' purulent opthalmia 547 

Inflammatory fever 131 

Inflammation, chronic, of womb.... 431 
do. powders against .... 182 
Inflammation, and its termina- 
tions 162 

do. of brain 171 

do. of eye 172 

do. of tongue 176 

do. of tonsils 177 

do. of larynx 1-78 

do. of trachea 179 

do. of nostrils, etc., ca- 
tarrh 179 

do. of bronchi 181 

do. of heart 370 

do. of lungs 184 

do. of pleura 184 

do. of stomach 185 

do. of bowels 186 

do. of pericardium 367 

do. of peritoneum 187 

do. ofkidney 187 

do. of liver 187 

do. of bladder *189 

do. of womb 430 

do. of urethra 190 

do. of veins 373 

Influenza 183 

Indolence and indulgence^ when 

specially dangerous 69 

Infusions, tonic, of calumba, 

orange-peel, or gentian 134 

Injection of chloride of soda 387 

do, purgative 479 

Ingesta, and egesta 37 

Inoculation of small-pox con- 
demned 537 

Insects, stings from." 567 

do. in the eyes or ears...., 577 

Intellect, not duly exercised, a 

cause of disease 28 

do. precocious, examples of... 29 
Intellectual function of animals.... 720 

Intestines, action of, on food 748 

do. Beaumont on, do 749 

Intense cold 576 



INDEX. 



803 



PAGES 

Iodide of lead ointment 348 

Iodine, footbath... 489 

do. poisoning by 557 

Irritation from blisters in chil- 
dren 587 

do. spinal 417 

Irritable womb 432 

Irish moss 87 

Ischuria 324 

Itch, the 298 

do. ointments for 299 

do. ointment 584 

do. washerwoman's, bakers' 297 

do. insect ." 298 

Itching or pruritis...... 304 

do. application for 291 

J 

Jaw, locked, in hysteria 425 

Jaundice, or icterus 309 

do. of infants 547 

K 

Kidneys, inflamed 187 

do. dropsy of 287 

do. granular disease of. 325 

do. inflammation of 828 

L 

Labor, when to be expected 454 

Lacteal absorbents 35 

Lacteals 718 

Land scurvy 302 

Laryngitis 178 

Larynx, inflammation of. - 178 

Laugh, sardonic 228 

Laurel rose, poison 565 

Lead colic 249 

do. iodide of. 348 

do. sign of 250 

Leaping 689 

Legs, enlarged veins of in preg- 
nancy 448 

Lemonade 90 

Lemon-peel tea 89 

Leprosy 296 

Lethargy 211 

Leucorrhoea, or whites 391 

do. from womb 394 



PAGES 

Leucorrhoea, from glands at neck 

of womb 394 

Lichen 294 

Life 705 

do. dangers to 609 

Lightning-stroke 676 

Lime, poison 556 

do. in the body , 737 

Lime-water, poison 566 

Liniments 584 

Linseed 605 

do. tea 90 

Litharge, poison 662 

Lithiasis 328 

Liver disease 188 

do. stimulated in hot climates... 811 

do. of sulphur a poison 660 

do. inflammation of. 187 

Liverwort 605 

Locked jaw, hysterics 425 

Locomotive exercises 678 

Longings 434 

Looseness of bowels 271 

Lotion, evaporating or cooling 136 

do. for chilblains 862 

do. various 583 

Low spirits 225 

Lozenges of manna 475 

Luncheon 67 

Lungs 718 

do. inflammation of. 184 

M 

Maccaroni pudding 94 

Madeira wine 78 

Mad dogs, poison 667 

Madness, canine 235 

Malaria, described 24 

do. conditions of its origin, 

etc 25 

Management during pregnancy.... 433 

Mania a potu 607 

Marching 682 

Marshmallow tea 90 

Marsh marigold, poison 562 

Meadow saff'ron 192 

do. do. poison 562 

Meals 67 

Measles 529 



804 



AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



PAGES 

Measles, false 288 

Measures and weights 793 

Meat, consumed Tby different na- 
tions 69 

Medicines for children 469 

do. forms of 583 

do. doses 798 

Medullary matter i. 710 

Menorrhagia 1 402 

Menstruation 396 

do. profuse 402 

Mesenteric decline 494 

do. glands 35 

Mercury 470 

do. as a poison 558 

do. when to discontinue 172 

do. -andchalk 603 

Mercurial mouth 514 

Metritis 430 

Miasms, unhealthy 27 

Miliary eruption 292 

Milk and soda-water 92 

do. and flour, boiled 92 

do. asses', artificial 92 

do. goats', do 91 

do. sago 95 

do. excessive flow of. 455 

do. abscess. 456 

do. drying up of. 462 

do. for children 485 

do. sickness 611 

do. fever 466 

do. leg .., 618 

Milky urine 274 

Millet-seed rash 292 

Mind, requires management 27 

do. and mental affections as 

cause of disease 27 

do. conditions of healthy 27 

Mineral waters 121 

Miscarriage, to prevent 450 

Mixed fever 135 

Mixtures, purgative 132 

do. stimulant 217 

do. restorative 80 

Monk's-hood, poison 562 

Monthly periods, or menstruation.. 396 
do. do. scanty or sup- 
pressed 401 



PAGES 

Monthly periods, too profuse 402 

do. do. painful 406 

do. do. drops for 408 

Morning sickness 442 

Mortification 170 

Mouth, canker in 514 

Mucilage of arrowroot 86 

do. tons les mois 86 

do. sago 86 

do. tapioca 86 

do. salep 86 

do. Iceland moss 87 

do. rice 88 

Mulled wine 96 

Mumps 177 

Muriatic acid and honey in diph- 
theria 513 

Muscles, effects on by corsets 32 

do. what they are 716 

Muscular fiber 710 

Mushrooms, as poisons 564 

Mustard poultice 685 

Mutton tea 89 

Muriatic acid, poison 555 

Mycoderm 538 

N 

Nails, ulcers about 622 

Narcotic Medicines 603 

Opium 

Morphine 

Meadow saffron 

Belladonna 

Aconite 

Chalk and opium 

Dover's powder 

Neck glands, scrofulous 483 

Nervous blindness 822 

Nephritis 328 

Nettle-rash 205 

Newton, Sir Isaac 29 

New-born infants 577 

Neuralgia 353 

Night blindness 316 

Nightshade, poison 565 

Nine-day fits 545 

Nipples, sore 438 

do. after delivery 454 

Nitric acid blister 253 



INDEX. 



805 



PAGES 

Niter as poison 660 

Nitro-muriatic acid lotion 583 

do. do. batli 583 

Nose, bleeding at 206 

do. copper 306 

Nostrils inflammation of. 179 

Nursing 460, 461 

Nutrition 62 

Nursing the sick 627 

Nux vomica, poison 565 

Nyctalopia 316 



Oatmeal gruel 87 

do. porridge 93 

Obstipatio 318 

Oil, castor, biscuits of. 479 

do. of viti-iol, poisoning by 555 

Ointment of iodide of lead 348 

Ointments 584 

Tartar emetic 
For eyelids 
For itch 
Of spermaceti 

Operation for cancer 887 

Opium, poisoning by 563 

Ophthalmia 172 

do. purulent, of children... 547 

do. do. of adults 173 

do. rheumatic 175 

do. gonorrheal 176 

do. strumous 174 

do. catarrhal 173 

Organization 706 

Organs, purifying the blood 36 

Orgeat 90 

Outlets for carbon 36 

Oxalate of lime, in urine 332 

Oxalic acid in urine 331 

do. poisoning by... t 556 

Oxide, carbonic 573 

Oyster 64 

P 

Packing, wet-sheet and blanket.... 58 

Painful monthly periods 406 

Pains in pregnancy 450 

do. from inflammation 610 

do. darting, of the heart 366 



PAGES 

Painters' colic 249 

Palpitation 363 

Palpitations in pregnancy 446 

Palsy 216 

Panada, chicken ■>.. 95 

do. bread 88 

Papulous scall 294 

Paraplegia 218 

Parasites 241 

Parent 707 

Partial palsy 218 

Paste, Ward's 209 

Passion, iliac 239 

Passions, to be regulated 31 

do. causes of neryous disor- 
ders 81 

Pericarditis, chronic 369 

Pericardium, inflammation of. 367 

Periods, retention of. 401 

Perspiration 40 

do. matters thrown off by. 41 

Perspiratory tubes 41 

Peritonitis, after delivery 463 

Peritonseum, inflammation of. 187 

Pessaries 389 

Phlebolites 375 

Phlebites 373 

Phlegmasia dolens 618 

Phosphates in urine 831 

Phosphorus, poisoning by 561 

do. in the body 737 

Physical training 654 

Physiology 705 

Piles 208 

do. ointment for 584 

do. powder for 595 

do. during pregnancy 447 

Pills, aperient 594 

do. dinner 321 

Pimples, dry 294 

do. from use of ointment 585 

Pityriasis 297 

Plague 203 

Plants, poisonous 562 

Pleura, inflammation of 184 

Pneumonia 184 

Poison lettuce, poison 563 

do. vine, poison 662 

Poisons 555 



806 



AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



PAGES 

Polypi of womb 409 

Poppy, poison.. 563 

Poor mans mixture 591 

Port wine 78 

Porridge, oatmeal 93 

Position 667 

Posset, sago -. 92 

Potassium, iodide of. 348 

Potash, poison 556 

do. carbonate of, poison 556 

Poultices, of bread and water 588 

do. of arrowroot 588 

do. of alum 588 

do. of charcoal 588 

do. of yeast 588 

do. of hemlock 588 

do. of linseed meal 588 

do. of carrot 589 

do. of chlorinated Soda 589 

do. of mustard 589 

Powders, Dr. Gregory's 591 

do. gray '. 603 

do. for fevers 182 

Pregnancy, management during... 433 

do. costiveness during 435 

do. exercise during 436 

do. clothing and bathing 

during... 436, 437 

do. signs of 440 

do. piles and palpitation 

during 446, 447 

do. whites and headache 

during 450 

do. pain in side during... 450 

do. cramps during 449 

Prevention of miscarriage 450 

do.- of disease 17 

Pressure in cancer 348 

Profuse menstruation 402 

Prolapse of anus 524 

do. of bladder 387 

do. of womb 388 

Prostate gland, enlargement of..... 381 

Prurigo 295 

Pruritus 304 

Prussic-acid as poison 563 

Psoriasis 297 

Pudding, arrowroot 92 

do. boiled bread 93 



PAGES 

Pudding, rice 94 

do. maccaroni or vermicelli... 94 

do. batter 94 

do. tapioca 94 

Puerperal fever 464 

do. intestinal irritation 465 

Purgative mixture 132 

do. injection 479 

Purpura 302 

Purulent ophthalmia 547 

Putrid fever 138 

Putty powder, poison 559 

Pyroligneous acid 541 

Pyrosis ,, 224 

Q 

Quacks and quackery 52 

Quinine mixture 141 

do. when to discontinue 195 

R 

Rash, nettle 205 

Raspberry vinegar-water 90 

Rationale of hydropathy 60 

Rectum, blood from 208 

do. stricture of. 375 

do. prolapse in children 524 

do. fissure of..... 376 

do. prolapse of. 373 

Red gum 548 

do. lead, poison 562 

do. precipitate, poison 558 

Remitting bilious fever 154 

Renal dropsy 287 

Rennet whey 91 

Repletion, disease of. 69 

Respiration 19 

Respiratory food 63 

Restorative mixture 80 

Resuscitati(Jn from drowning....... 574 

Retention of the periods 401 

Re-vaccination 537 

Rheumatism 191 

do. chronic 193 

Rheumatic ophthalmia., 169 

do. fever 185 

Rice and apples 93 

do. pudding 94 

do. gravy 96 



INDEX. 



807 



PAGES 

Rickets 492 

Ringworm 637 

Roasting 66 

Rooms, dimensions and aeration... 23 

Rose rash 288 

Round worm 245 

Rubeola 529 

Rumination, human 318 

Rue, poison 565 

Rum 80 

Running 686 

do. tetter 293 

Rupia 288 

Ruptures 582 

Rye grass, poison 566 

do. spurred 564 

S 

Sago posset 92 

do. milk 95 

Sal ammoniac, poison , 556 

Salivation, signs of 172 

do. during pregnancy 448 

Salt, its uses 737 

do. of tin, poison 559 

Salting and pickling 64 

Saltpeter, poison 560 

Sarsaparilla 605 

Sausages 667 

do. at times poisonous 64 

Sardonic laugh 228 

Scall, running 293 

do. papulous 294 

Scabies, the itch 298 

Scarlet fever 198 

Scalds or burns 356, 577 

Scar, vaccine 536 

Scirrhus 345 

Scour, green 515 

Scrofula 482 

do. in the ear 492 

do. do. neck 491 

Scurvy, land 302 

do. sea 303 

Sea-sickness 251 

Secretions, use of. 34 

Secretory glands 719 

Sedentary habits 42 

Serpents, poison 667 



PAGES 

Shingles 205 

Sickness, morning 442 

Sick stomach 611 

Siesta, necessary in certain cases.. 21 

Signs of pregnancy ., 440 

Silver, as a poison 560 

Sinapism 585 

Skin diseases 288 

do. pores of. 41 

do. of stomach distended in preg- 
nancy 449 

Sleep, duration of. 31 

Small-pox 196 

Smelling-salts, poison 556 

Snake-bites 567 

Snow-balls of rice, etc 93 

Soda, carbonate of, poison 556 

do. washing, poison 556 

do. water and milk 92 

do. chloride of, injection 387 

Solid portions of the body 705 

Sonderland on cow-pox 536 

Sore throat '... 177 

do. nipples after delivery 454 

Soup, rice 94 

do. vermicelli 94 

do. maccaroni 94 

So wans 93 

Spanish fly, poison 661 

Specifics 715 

Spermaceti ointment 584 

Spinal curvature 413 

do. irritation 417 

Spirit lotion 583 

Spirits, ardent, poison 564 

Spontaneous combustion 83 

Spotted fever 138 

Sprains 678 

Squills, poison 562 

Staves acre, poison 562 

Sterility, female 428 

Still-born children 642 

Stimulant Medicines '. 596 

Arnica 

Horseradish 

Ammonia 

Assafetida 

Camphor 

Cantharides 



808 



AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



PAGES 

Stimulant Medicines 596 

Musk 

Nutmeg 

Valerian 

Ether 

Ginger, nutmeg 

Pepper, capsicum 

Wine 

Stings of insects 567 

Stomach, blood from 207 

do. inflammation of 185 

do. its action on food 745 

do. Beaumont's observations. 746 

Stomatitis 509 

Stones, gall 313 

do. urinary 328 

Strangury 323 

Strangling 576 

Stricture 321, 380 

Stroke of lightning 576 

Strophulus 548 

Study and play should alternate... 30 

Stupes 590 

Strychnine, poison 564 

Substances, foreign, in eye or ear.. 577 

Sudamina 292 

Sudorifics 601 

Sugar in urine 332 

do. of lead, poison 562 

Sulphur in the body 737 

do. liver of. 560 

Sulphuric acid, poisoning by 555 

Sulphureted hydrogen 573 

Supper 68 

Suspended animation 570 

Sun 709 

Sunstroke 171 

Sweat promoters 601 

Sweetbread 96 

Sycosis 307 

Syncope 232 

T 

Tapeworm , 243 

Tapioca pudding 94 

Tartar emetic, poison 557 

Tea 68 

do. linseed 90 

do. beef and mutton 89 



PAGES 

Tea, chicken 89 

do. lemon-peel 89 

do. marsh-mallow 90 

do. apple. 89 

Teeth, permanent 480 

Teething 479 

Test, Bryce's 534 

Tests for urinary gravel 337 

Tetanus 229 

Tetter, or herpes 289 

do. running or crusted 293 

do. dry 297 

Thirst 724 

Thorn-apple, poison 565 

Threadworm 246 

Thrush 509 

Tic douloureux 353 

Tin as a poison 559 

Tinea capitis 537 

Tissue, cellular indurated 546 

Toast-water 89 

Tobacco, poison 564 

do. clyster 230 

Tonic Medicines 598 

Calumba 

Chamomile 

Quinine 

Gentian 

Orange-peel 

Cloves 

Cascarilla 

Angustura bark 

Peruvian bark 

Quassia 

Valerian 

Tongue, inflammation of. 176 

do. tied 543 

Tonsils, inflammation of 177 

Tonsilitis 177 

Toothache 352 

do. during pregnancy 448 

Trachea, inflammation of. 179 

Tractors, Perkins's metallic 53 

Training 660 

Treatment, modes of. 130 

do. of childhood 486 

Trichina spiralis 623 

Tripe 96 

Turbeth mineral, poison 558 



INDEX. 



809 



Turnips and carrots '. 94 

Turtle soup 89 

Tympany 281 



Ulcer, atonic 288 

do. corroding, of the womb 412 

Umschlags 60 

Urethra, inflammation of. 190 

Urethritis 190 

Uric acid gravel 331 

Urinary gravel 330 

do. stone 328 

Urine, pus, or mucus in 332 

do. difficulty of passing 323 

do. immoderate flow of. 322 

do. suppression of 324 

do. sugar in, see diabetes 332 

Urticaria 205 



Vaccination described 532 

Vaccine vesicle 533 

Valves of the heart, disease of 370 

Varicella 288 

Vaulting 694 

Veal tea 89 

Vegetable diet 736 

do. albumen, caseine, and 

fibrine 63 

do. kingdom 708 

Vegetables, constituents of. 63 

do. plain boiled 94 

Vegetarians 74 

Veins 718 

do. of legs, enlarged in preg- 
nancy 448 

do. inflammation of. 373 

Venereal disease 379 

Ventilation, supply of air necessary 

for life 18, 19 

do. good effects from 572 

Verdigris, poison 559 

Vermicelli soup 94 

Vermillion, poison 558 

Vertigo 233 

Vesicular eruption 205 

Vinegar, raspberry water 90 



PAGES 

Vinegar and tamarind wheys 91 

Virgin's bower, poison 562 

Vitriol, blue, poison 559 

Vifriol, white, poison 560 

do. oil of, do. .•«. 555 

do. spirits of, poison 555 

Vomiting 224, 251 

do. of blood 207 

W 

Walking 680 

Wall-pepper, poison 562 

Ward's paste 209 

Warts 301 

Washerwoman's itch 297 

Washes for eyes 583 

Water-cure, rationale of. 60 

do. brash 224 

do. in pericardium 369 

do. in the head 507 

do. do. spurious 504 

do. raspberry vinegar 90 

do. barley 90 

do. how to freeze 583 

Waters, mineral 121 

do. aluminous 123 

do. sulphureous 124 

do. saline 124 

do. calcareous 125 

do. alkaline 125 

do. Glauber's salts 125 

do. effects of mineral in dis- 
ease 126 

Watery discharge from the womb.. 412 

Weaning 462 

do. indigestion during 515 

Weights and measures 793 

Wet-sheet, in hydropathy 58 

Whey, rennet 91 

do. vinegar and tamarind 91 

do. mustard 91 

Whisky 80 

Whites, the 391 

do. during pregnancy 450 

White vitriol, poison 560 

do. copperas, poison 560 

do. lead, do 562 

Whitlow 622 

Whooping-cough 548 



810 



AMERICAN HOUSEHOLD BOOK OF MEDICINE. 



PAGES 

Whortleberry leaves, infusion of... 210 

Wines 76 

do. white, whey 91 

do. barley aromatic "96 

do. mulled 96 

do. of United States 77 

Wine-glass, how much 793 

Wind on stomach, cure of 238 

Windy swelling 280 

Womb, cancer of 383 

do. falling down of. 388 

do. polypus of. -. 409 

do. cauliflower excrescence of.. 411 

do. corroding ulcer of 412 

do. watery discharges from 412 

do. inflammation of 430 

do. irritable 432 

do. leucorrhoea from 394 

do. chronic inflammation of..... 431 

Women, diseases of 383 



PAGES 

Worm medicines 592 

do. fever 501 

do. powder, poison 559 

Worms 241 

do. tape 243 

do. round 245 

do. thread 246 

do. guinea 248 

do. in face 305 

Wounds 579 

Y 

Yellow fever 162 

do. gum 547 

do. headed pimples produced 

by ointments, etc 584 

Z 

Zinc, as a poison 560 




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